Provider Demographics
NPI:1154785632
Name:MARINARO, JESSICA ANN (MD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:MARINARO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9600 BLACKWELL RD STE 500
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3783
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:855-420-8517
Practice Address - Street 1:901 DULANEY VALLEY RD STE 616&100
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2600
Practice Address - Country:US
Practice Address - Phone:410-512-8300
Practice Address - Fax:855-334-8171
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY308371-01208800000X
VA0101276496208800000X
MDD0095573208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology