Provider Demographics
NPI:1730578113
Name:MARINO ACUPUNCTURE PC
Entity type:Organization
Organization Name:MARINO ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MS, LAC
Authorized Official - Phone:585-857-3456
Mailing Address - Street 1:980 WESTFALL RD
Mailing Address - Street 2:BLDG 200, STE 250
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2607
Mailing Address - Country:US
Mailing Address - Phone:585-857-3456
Mailing Address - Fax:585-454-4949
Practice Address - Street 1:233 ALEXANDER ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-2518
Practice Address - Country:US
Practice Address - Phone:585-857-3456
Practice Address - Fax:585-454-4949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004293171100000X
NYX011569111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty