Provider Demographics
NPI:1811006885
Name:MARIANI, JOHN K (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:K
Last Name:MARIANI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:570 EGG HARBOR RD
Practice Address - Street 2:SUITE C4
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2359
Practice Address - Country:US
Practice Address - Phone:609-267-9400
Practice Address - Fax:609-267-9457
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB41231207X00000X
NJ25MB04123100207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ455694Medicare PIN
NJE06087Medicare UPIN