DR. TEODORO REYES MARIANO JR. (NPI# 1477577583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477577583 |
| Entity Type | Individual |
| Full Name | DR. TEODORO REYES MARIANO JR. |
| Credential | M.D. |
| Practice Address |
21 Union Hill Dr Spencerport NY 14559-1965 |
| Mailing Address |
34 West Ave Brockport NY 14420 |
| Practice Telephone | 5853524411 |
| Mailing Telephone | 5856372161 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2018-05-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 129789 | NY | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
129789 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | UNITED HEALTHCARE PPO | 444111502 | 01 |
| NY | AETNA PPO | 5339337 | 01 |
| NY | PREFERRED CARE CARDIOLOGY | MD2826 | 01 |
| NY | BLUE CHOICE PROVIDER NO. | P010129789 | 01 |
| NY | NYS WORKERS COMP | 224911 | 01 |
| NY | BCBS OF WESTERN NY | 80121911498001 | 01 |
| NY | 00487921 | 05 | |
| NY | BLUE CROSS BLUE SHIELD | 0524 | 01 |
| NY | PREFERRED CARE PROVIDER | 100768BJ | 01 |
| NY | AETNA HMO | 2564331 | 01 |
| NY | PREFERRED CARE PROVIDER | MD1826 | 01 |
| Street Address |
21 UNION HILL DR |
| City | SPENCERPORT |
| State | NY |
| Zip Code | 14559-1965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679526818 | George R Stefanos II | Legal Medicine | 21 Union Hill Dr, Suite B, Spencerport, NY 14559-1965 | 2006-05-18 |
| 1609153519 | George R. Stefanos M.d. P.c | Internal Medicine | 21 Union Hill Dr, Spencerport, NY 14559-1965 | 2011-11-05 |
| 1063795276 | Teodoro Mariano Jr Md PC | Internal Medicine | 21 Union Hill Dr, Spencerport, NY 14559-1965 | 2011-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891343406 | Barbara Lucas | Technician | 3429 Big Ridge Rd., Spencerport, NY 14559 | 2019-08-27 |
| 1003302720 | Melissa Sue Delaporte | Licensed Practical Nurse | 1055 Ogden Parma Tl Rd, Spencerport, NY 14559 | 2018-07-05 |
| 1235648130 | Kathleen Simonds | Registered Nurse | 3589 Big Ridge Road, Spencerport, NY 14559 | 2017-09-22 |
| 1972030757 | Hamad Ghazle | Radiologic Technologist | 7 Chamber Valley Estates, Spencerport, NY 14559 | 2017-05-11 |
| 1306393855 | Gloria Gregory | Licensed Practical Nurse | 1279 Vroom Rd, Spencerport, NY 14559 | 2016-09-01 |
| 1952763609 | Sharese Dyson | Licensed Practical Nurse | 104 Teaberry Drive, Spencerport, NY 14559 | 2016-03-22 |
| 1447646369 | Elizabeth K Gagnier | Family Medicine | 4 Land Re Way Ste 100, Spencerport, NY 14559 | 2015-04-07 |
| 1578840419 | Lynn Ann Rinaldo | Occupational Therapist | 3599 Big Ridge Road, Spencerport, NY 14559 | 2011-11-07 |
| 1972893709 | Teresa Marie Zappia-sinicropi | Physical Therapist | 1 Ranger Rd, Spencerport, NY 14559 | 2011-04-13 |
| 1568767499 | Tracy Lee Gillette | Counselor | 115 Webster Rd., Spencerport, NY 14559 | 2011-01-25 |
| Find all providers in zip 14559 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619520244 | Katherine Management Group Inc | Internal Medicine | 67 Sarah Cir, Spencerport, NY 14559-9592 | 2019-07-23 |
| 1700925542 | .hari P Garg | Internal Medicine | 22 Twin Ponds Dr, Spencerport, NY 14559-1037 | 2007-02-06 |
| 1407800543 | Marionito N Montalbo | Internal Medicine | 42 Nichols St Ste 10, Spencerport, NY 14559-2196 | 2006-05-22 |
| 1124003298 | Jose O Santiago | Internal Medicine | 42 Nichols St, Spencerport, NY 14559-2180 | 2005-12-13 |
| 1528412897 | Daniel Vieira Lighthouse | Internal Medicine | 42 Nichols St Ste 10, Spencerport, NY 14559-2196 | 2016-04-22 |
| 1609153519 | George R. Stefanos M.d. P.c | Internal Medicine | 21 Union Hill Dr, Spencerport, NY 14559-1965 | 2011-11-05 |
| 1063795276 | Teodoro Mariano Jr Md PC | Internal Medicine | 21 Union Hill Dr, Spencerport, NY 14559-1965 | 2011-09-23 |
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| 1063028967 | Adults Medical Care, P.C. | Internal Medicine | 89 04 Northern Blvd, Ground Floor, Jackson Heights, NY 11372 | 2020-09-17 |
| 1578177929 | Ar Personal Medical Care P.C. | Internal Medicine | 4102 75th Street, Elmhurst, NY 11373-3745 | 2020-09-03 |
| 1295348019 | Vault Medical Group Pa | Internal Medicine | 133 E 58th St Ste 512, New York, NY 10022-1145 | 2020-08-31 |
| 1770196602 | Julia A Mason | Internal Medicine | 78 Crescent Dr, Albany, NY 12208-1230 | 2020-08-29 |
| 1205447745 | Princeton Longevity Medical of New York Pllc | Internal Medicine | 1 World Trade Ctr Ste 71d, New York, NY 10007-0089 | 2020-08-10 |
| Find all providers with the same taxonomy | ||||
| City | SPENCERPORT |
| Zip Code | 14559 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.