Mariano, Domenic L

Mariano, Domenic L is an individual health care provider with primary practice located at 946 Bloomfield Ave , Glen Ridge NJ 07028. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Mariano, Domenic L can be contacted via phone (973) 743-1121.

Contact Information

Primary practice address
946 Bloomfield Ave Glen Ridge NJ 07028
Fax: (973) 743-2627
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MB05816800 New Jersey

Profile Details

NPI number 1457327975
LBN Legal business name Mariano, Domenic L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2006
Last updated Sep 24th, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457327975 NPPES
New Jersey MEDICAID 7338201

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