Provider Demographics
NPI:1598859936
Name:MARINARO PASCALE, LAURIE A (APN)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:A
Last Name:MARINARO PASCALE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MS
Other - First Name:LAURIE
Other - Middle Name:ANN
Other - Last Name:DACUNZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:1100 WESTCOTT DRIVE
Mailing Address - Street 2:SUITE G3
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822
Mailing Address - Country:US
Mailing Address - Phone:908-788-1710
Mailing Address - Fax:908-788-1716
Practice Address - Street 1:1100 WESTCOTT DRIVE
Practice Address - Street 2:SUITE G3
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822
Practice Address - Country:US
Practice Address - Phone:908-788-1710
Practice Address - Fax:908-788-1716
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00067200363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0094820Medicaid