Individual
MARINA A MAULUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
1540 ELLICOTT CREEK RD, STE 1, TONAWANDA, NY 14150-2935
(716) 886-8289
(716) 886-8303
Mailing address
1540 ELLICOTT CREEK RD, STE 1, TONAWANDA, NY 14150-2935
(716) 886-8289
(716) 886-8303
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N003952
NY
213EP1101X
Primary Podiatric Medicine Podiatrist
N003952
NY
213ER0200X
Radiology Podiatrist
N003952
NY
213ES0000X
Sports Medicine Podiatrist
N003952
NY
213ES0131X
Foot Surgery Podiatrist
N003952
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010254001
UNIVERA
NY
01
—
00010254002
UNIVERA ELLICOTT CREEK OF
NY
01
—
000500995001
BCBS ALL
NY
01
—
000500995004
BCBS DME
NY
05
—
00975291
—
NY
01
—
480005207
MEDICARE RAILROAD
NY
01
—
8905488
INDEPENDENT HEALTH
NY
Enumeration date
05/01/2006
Last updated
03/02/2017
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