MEDICARE: ANA MARIN

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
1	172V00000X	Community Health Worker		RI

General Provider Information

NPI Number	:	1053283176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA MARIN

Provider Business Mailing Address
First Line	:	15 PALM ST
Second Line	:
City	:	NORTH PROVIDENCE
State	:	RI
Zip	:	02904-4622
Country	:	US
Telephone Number	:	401-626-8283
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 PALM ST
Second Line	:
City	:	NORTH PROVIDENCE
State	:	RI
Zip	:	02904-4622
Country	:	US
Telephone Number	:	401-626-8283
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2025
Last Update Date	:	09/18/2025

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Directions to “ ANA MARIN ” Practice Location

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