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NPI Code Detail

MEDICARE: MS. JACQUELINE MARINELLI MS ED

MEDICARE: MS. JACQUELINE MARINELLI MS ED
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
1174400000XSpecialist995096NY

General Provider Information

NPI Number : 1801150834
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JACQUELINE MARINELLI MS ED
Provider Business Mailing Address
First Line : PO BOX 11097
Second Line :
City : PHOENIX
State : AZ
Zip : 85061-1097
Country : US
Telephone Number : 855-639-7500
Fax Number :
Provider Business Practice Location Address
First Line : 3300 W CAMELBACK RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-3030
Country : US
Telephone Number : 602-639-7500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2012
Last Update Date : 10/09/2019

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