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General NPI Number Information
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NPI Number | 1053700120
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Entity Type | Individual
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Provider Name | AMANDA SUE MARINO C.R.N.P.
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Gender | Female
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Dates
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Enumeration Date | 01/13/2015
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 1627 CHEW ST FL 1
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City | ALLENTOWN
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State | PA
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Zip | 18102-3648
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Country | US
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Telephone | 610-402-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 700 COVENTRY DR
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865-1972
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Country | US
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Telephone | 908-454-4666
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Fax | 908-454-2332
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | SP012936
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License Number State | PA
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