Mederos, Mariano
Mederos, Mariano is an individual health care provider with primary practice located at 311 Saint Nicholas Ave Ste E , Ridgewood NY 11385-2296. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Mederos, Mariano can be contacted via phone (718) 894-2500.Contact Information
Primary practice address
311 Saint Nicholas Ave Ste E
Ridgewood NY 11385-2296
Phone: (718) 894-2500
Fax: (718) 417-4535
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 156182 | New York |
Profile Details
| NPI number | 1598743007 |
|---|---|
| LBN Legal business name | Mederos, Mariano |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 4th, 2006 |
| Last updated | Jun 6th, 2016 - about 8 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 | 1598743007 | NPPES |
| New York | MEDICAID | 00947791 |
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