Tavarez, Marino D

Tavarez, Marino D is an individual health care provider with primary practice located at 12 Leach Rd Lyons Health Center, Lyons NY 14489-9732. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Tavarez, Marino D can be contacted via phone (315) 946-6075.

Contact Information

Primary practice address
12 Leach Rd Lyons Health Center Lyons NY 14489-9732
Phone: (315) 946-6075
Fax: (315) 946-4254
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 232852 New York
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD441558 Pennsylvania
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 12860 Hawaii
Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine 2083P0901X 232852 New York
Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine 2083P0901X MD441558 Pennsylvania
Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine 2083P0901X 12860 Hawaii

Profile Details

NPI number 1518049865
LBN Legal business name Tavarez, Marino D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2006
Last updated Jan 5th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518049865 NPPES
New York MEDICAID 02868248

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