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NPI Code Detail

MEDICARE: CARLY MARINO

MEDICARE: CARLY MARINO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianPA

General Provider Information

NPI Number : 1457203168
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLY MARINO
Provider Business Mailing Address
First Line : 815 PINE ST
Second Line :
City : MAYFIELD
State : PA
Zip : 18433-1806
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2000 ASH ST
Second Line :
City : SCRANTON
State : PA
Zip : 18510-1546
Country : US
Telephone Number : 570-871-4751
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2026
Last Update Date : 02/13/2026

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Directions to “ CARLY MARINO ” Practice Location

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