Provider Demographics
NPI:1801391644
Name:MARINO, DAVID PAUL (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:MARINO
Suffix:
Gender:M
Credentials:PHD
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Other - First Name:
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Mailing Address - Street 1:2150 HARRISBURG PIKE
Mailing Address - Street 2:STE 200B
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-544-3172
Mailing Address - Fax:717-544-3229
Practice Address - Street 1:2150 HARRISBURG PIKE
Practice Address - Street 2:STE 200B
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3172
Practice Address - Fax:717-544-3229
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPS018457103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist