Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 178991 | NY |
N | 2081P2900X | Pain Medicine | 25MA06101800 | NJ |
NPI | 1184656373 |
---|---|
Provider Name | Dr. Robert A Marini |
First Address | Belleville, NJ 07109-1123 |
Second Address | Belleville, NJ 07109-1123 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 23/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F66392 | (02) | NJ |