Carrillo, Mario
Carrillo, Mario is an individual health care provider with primary practice located at 1676 Sunset Ave 4Th Floor, Utica NY 13502. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Carrillo, Mario can be contacted via phone (315) 624-4690.Contact Information
Primary practice address
1676 Sunset Ave 4Th Floor
Utica NY 13502
Phone: (315) 624-4690
Fax: (315) 624-4840
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 213540 | New York |
Profile Details
| NPI number | 1053491936 |
|---|---|
| LBN Legal business name | Carrillo, Mario |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 16th, 2006 |
| Last updated | Mar 23rd, 2016 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053491936 | NPPES |
| New York | MEDICAID | 01976636 |
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