Provider Demographics
NPI:1588989446
Name:MARCIANO, REETTA MARJA (MD)
Entity type:Individual
Prefix:MS
First Name:REETTA
Middle Name:MARJA
Last Name:MARCIANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6608
Mailing Address - Country:US
Mailing Address - Phone:308-419-9423
Mailing Address - Fax:
Practice Address - Street 1:1350 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6608
Practice Address - Country:US
Practice Address - Phone:308-419-9423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1292752084P0800X
OH35.1292752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry