Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | MD045804L | PA |
N | 208200000X | Surgeon | MD045804L | PA |
N | 208600000X | Surgeon | MD045804L | PA |
NPI | 1831115443 |
---|---|
Provider Name | Dr. Ignazio R Marino |
First Address | Philadelphia, PA 19106-4404 |
Second Address | Philadelphia, PA 19107-5563 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 08/07/2007 |