Provider Demographics
NPI:1699269647
Name:MARINESCU, RADU
Entity type:Individual
Prefix:
First Name:RADU
Middle Name:
Last Name:MARINESCU
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 1:9140 W HEARN RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-3790
Mailing Address - Country:US
Mailing Address - Phone:623-977-9399
Mailing Address - Fax:
Practice Address - Street 1:9140 W HEARN RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-3790
Practice Address - Country:US
Practice Address - Phone:623-977-9399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health