National Provider Identifier
Marino D Tavarez, M.D.
Marino D Tavarez, M.D. is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Lyons, NY and a listed phone number of (315) 946-6075.
Profile Overview
- NPI
- 1518049865
- Provider Type
- Individual
- Primary Specialty
- Family Medicine Physician
- Enumeration Date
- October 19, 2006
- Last Updated
- January 05, 2015
Practice Location
- 12 Leach RD
- Lyons Health Center
- Lyons, NY 14489-9732
Phone: (315) 946-6075
Specialties
- Family Medicine Physician (207Q00000X)
- Family Medicine Physician (207Q00000X)
- Public Health & General Preventive Medicine Physician (2083P0901X)
Full Record
- NPI
- 1518049865
- Entity Type
- Individual
- Last Name
- Tavarez
- First Name
- Marino
- Middle Name
- D
- Credential
- M.D.
- Mailing Street Address
- 12 Leach RD
- Mailing Address Line 2
- Lyons Health Center
- Mailing City
- Lyons
- Mailing State
- NY
- Mailing ZIP Code
- 14489-9732
- Mailing Country
- US
- Mailing Phone
- (315) 946-6075
- Mailing Fax
- (315) 946-4254
- Practice Street Address
- 12 Leach RD
- Practice Address Line 2
- Lyons Health Center
- Practice City
- Lyons
- Practice State
- NY
- Practice ZIP Code
- 14489-9732
- Practice Country
- US
- Practice Phone
- (315) 946-6075
- Practice Fax
- (315) 946-4254
- Enumeration Date
- October 19, 2006
- Last Updated
- January 05, 2015
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Medicine Physician (207Q00000X), Family Medicine Physician (207Q00000X), Public Health & General Preventive Medicine Physician (2083P0901X)
- Other Identifiers
- 02868248 (NY)