Provider Demographics
NPI:1568905313
Name:MARINO, JOSEPH ROCCO (DTR)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ROCCO
Last Name:MARINO
Suffix:
Gender:M
Credentials:DTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1061
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08226-7061
Mailing Address - Country:US
Mailing Address - Phone:609-204-6777
Mailing Address - Fax:
Practice Address - Street 1:920 ASBURY AVE
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:NJ
Practice Address - Zip Code:08226-3536
Practice Address - Country:US
Practice Address - Phone:609-204-6777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ136A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes136A00000XDietary & Nutritional Service ProvidersDietetic Technician, Registered