Provider Demographics
NPI:1326137936
Name:MARINARI, ROSALIE K (MD)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:K
Last Name:MARINARI
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 1:211 BARCLAY PAVILION W
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2129
Mailing Address - Country:US
Mailing Address - Phone:856-429-5556
Mailing Address - Fax:856-429-2466
Practice Address - Street 1:211 BARCLAY PAVILION W
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2129
Practice Address - Country:US
Practice Address - Phone:856-429-5556
Practice Address - Fax:856-429-2466
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA27628207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
016020OtherAETNA
NJ3333906Medicaid
016020OtherAETNA
NJ3333906Medicaid