Provider Demographics
NPI:1275359143
Name:MARINO, GIOVANNI JOSEPH
Entity type:Individual
Prefix:
First Name:GIOVANNI
Middle Name:JOSEPH
Last Name:MARINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 WILLIS HILL RD
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-9114
Mailing Address - Country:US
Mailing Address - Phone:585-445-4236
Mailing Address - Fax:
Practice Address - Street 1:700 US HIGHWAY 46 EAST
Practice Address - Street 2:SUITE 420
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004
Practice Address - Country:US
Practice Address - Phone:973-882-3456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic