Individual
WANDA TEODOROWICZ-MARINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2242 CENTRAL PARK AVE, YONKERS, NY 10710-1457
(914) 793-7111
(914) 793-1325
Mailing address
2242 CENTRAL PARK AVE, YONKERS, NY 10710-1457
(914) 793-7111
(914) 793-1325
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
143436
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00851501
—
NY
01
—
0091319
GHI
—
01
—
0888912
AETNA HMO
—
01
—
133295758
TAX ID
NY
01
—
143436
MEDICAL LICENCE
NY
01
—
143436A-40
1199
—
01
—
18002947
RAILROAD MEDICARE
NY
01
—
4412490
AETNA PPO
—
01
—
P1218912
OXFORD ID
—
Enumeration date
06/25/2006
Last updated
03/07/2023
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