Healthcare Provider Details

I. General information

NPI: 1225177231
Provider Name (Legal Business Name): LIZABETH L. MARINARO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIZABETH MARINARO MD

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 LOMAS BLVD NE
ALBUQUERQUE NM
87106-2719
US

IV. Provider business mailing address

970 BONITA ROSAS RD NW
LOS RANCHOS NM
87107-7128
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-2445
  • Fax:
Mailing address:
  • Phone: 505-573-5704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number2004-0822
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: