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NPI Code Detail

MEDICARE: ANDREW DAVID MARINO

MEDICARE: ANDREW DAVID MARINO
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
1225100000XPhysical Therapist11934SC
2225100000XPhysical Therapist213937AK
3225100000XPhysical Therapist301992CA
4225100000XPhysical TherapistP20971NC

General Provider Information

NPI Number : 1396493540
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW DAVID MARINO
Provider Business Mailing Address
First Line : 2122 YORK RD STE 300
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1925
Country : US
Telephone Number : 570-550-0168
Fax Number :
Provider Business Practice Location Address
First Line : 7880 ALEXANDER PROMENADE PL STE 100
Second Line :
City : RALEIGH
State : NC
Zip : 27617-1918
Country : US
Telephone Number : 919-583-7223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2022
Last Update Date : 05/12/2025

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Directions to “ ANDREW DAVID MARINO ” Practice Location

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