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General NPI Number Information
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NPI Number | 1821096397
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Entity Type | Individual
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Provider Name | PAUL MARINO MD
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Gender | Male
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 426 W 52ND ST
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City | NEW YORK
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State | NY
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Zip | 10019-6302
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Country | US
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Telephone | 212-459-8308
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Fax |
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Provider Business Mailing Address
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Address Line | 111 W 94TH ST APT 4H
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City | NEW YORK
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State | NY
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Zip | 10025-7020
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Country | US
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Telephone |
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Fax |
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 185109
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License Number State | NY
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