MEDICARE: MR. LOUIS ANTHONY MARINI LCSW

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	1041C0700X	Clinical Social Worker	R053277	NY

General Provider Information

NPI Number	:	1447335872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LOUIS ANTHONY MARINI LCSW

Provider Business Mailing Address
First Line	:	927 RHINELANDER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-3415
Country	:	US
Telephone Number	:	718-239-5500
Fax Number	:	718-792-8882

Provider Business Practice Location Address
First Line	:	3146 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-5706
Country	:	US
Telephone Number	:	718-239-5500
Fax Number	:	718-792-8882

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

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	07/08/2007

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