Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 274837 | MA |
NPI | 1093000390 |
---|---|
Provider Name | Evan Frank Marino |
First Address | Methuen, MA 01844-5044 |
Second Address | Methuen, MA 01844 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2011 |
Last Update Date | 30/08/2018 |