Provider Demographics
NPI:1285664656
Name:DEMARINO, GEORGINE B (MD)
Entity Type:Individual
Prefix:MRS
First Name:GEORGINE
Middle Name:B
Last Name:DEMARINO
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 1:320 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-2459
Mailing Address - Fax:412-359-8233
Practice Address - Street 1:1907 LEBANON CHURCH RD
Practice Address - Street 2:
Practice Address - City:WEST MIFFLIN
Practice Address - State:PA
Practice Address - Zip Code:15122-2432
Practice Address - Country:US
Practice Address - Phone:412-650-7830
Practice Address - Fax:412-650-7831
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037914E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAA03036Medicare UPIN
PA472598Medicare ID - Type Unspecified