Provider Demographics
NPI:1417768789
Name:MARINO, ISABELLA
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:
Last Name:MARINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 W 5TH AVE # 225
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-4899
Mailing Address - Country:US
Mailing Address - Phone:614-224-6420
Mailing Address - Fax:
Practice Address - Street 1:2323 W 5TH AVE # 225
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-4899
Practice Address - Country:US
Practice Address - Phone:614-224-6420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant