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General NPI Number Information
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NPI Number | 1548745326
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Entity Type | Individual
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Provider Name | KARINA MARIN PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 09/27/2018
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Last Update Date | 05/17/2024
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Provider Practice Location Address
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Address Line | 55 MEADOWLANDS PKWY
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City | SECAUCUS
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State | NJ
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Zip | 07094-2977
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Country | US
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Telephone | 201-370-0449
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Fax | 434-423-4466
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Provider Business Mailing Address
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Address Line | 7 VAN EYCK CT
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City | LYNDHURST
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State | NJ
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Zip | 07071-2714
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Country | US
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Telephone | 201-921-8649
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Fax | 434-423-4466
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00492500
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License Number State | NJ
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