Poliseno, Marino A

Poliseno, Marino A is an individual health care provider with primary practice located at 1050 Clove Rd , Staten Island NY 10301-3627. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Poliseno, Marino A can be contacted via phone (718) 442-4300.

Contact Information

Primary practice address
1050 Clove Rd Staten Island NY 10301-3627
Phone: (718) 442-4300
Fax: (718) 816-8369
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 225825 New York

Profile Details

NPI number 1578550596
LBN Legal business name Poliseno, Marino A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2005
Last updated Jul 16th, 2015 - about 10 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 1578550596 NPPES
Other 7166589 AETNA
MEDICAID 02590985 AETNA
Other 0297012 AETNA

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