Individual
CYNTHIA M MARINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3200 WEST ST, CANANDAIGUA, NY 14424-1722
(585) 905-0061
Mailing address
3200 WEST ST, CANANDAIGUA, NY 14424-1722
(585) 905-0061
(585) 412-6612
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
002173
NY
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
002173
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000570164004
COMMUNITY BLUE
NY
01
—
0107647
INDEPENDENT HEALTH
NY
Enumeration date
01/10/2006
Last updated
01/10/2020
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