Doctor Name: | PAUL ANTHONY MARINO |
NPI Number: | 1982093019 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP-BC |
License Number: | COA.16843-NP |
Business Practice Address: | 138 Rockdale Rd Follansbee, WV - 260371658 |
Business Phone Number: | 3045271747 |
Business Fax Number: | |
Mailing Address: | 169 Locust Ln, FOLLANSBEE |
State: | WV |
Postal Code: | 260371623 |
Phone Number: | 3047946586 |
Fax Number: | |
NPI Enumeration Date: | 01/13/2015 |
NPI Last Update Date: | 01/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | COA.16843-NP |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |