MEDICARE: CHARLES A MARINELLO DPT

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	225100000X	Physical Therapist	048987	NY

General Provider Information

NPI Number	:	1831811462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES A MARINELLO DPT

Provider Business Mailing Address
First Line	:	3319 AVENUE N
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2605
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	945 KINGS HIGHWAY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-2336
Country	:	US
Telephone Number	:	718-258-3300
Fax Number	:

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

Provider Enumeration Date	:	09/12/2022
Last Update Date	:	12/10/2025

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Directions to “ CHARLES A MARINELLO DPT” Practice Location

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