Provider Demographics
NPI:1821032384
Name:MARINO, ANTHONY R (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:R
Last Name:MARINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 RIVERSIDE ST
Mailing Address - Street 2:STE 101
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1373
Mailing Address - Country:US
Mailing Address - Phone:603-883-0091
Mailing Address - Fax:603-881-3739
Practice Address - Street 1:17 RIVERSIDE ST
Practice Address - Street 2:STE 101
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1373
Practice Address - Country:US
Practice Address - Phone:603-883-0091
Practice Address - Fax:603-881-3739
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8319207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1932256914OtherNPI, PROVIDER LOCATION
NH1881772242OtherNPI, PROVIDER LOCATION
NH0102168Y0NH01OtherANTHEM BCBS PROVIDER #
NH1801952692OtherNPI, PROVIDER LOCATION
NH1841320207OtherNPI, PROVIDER LOCATION
NHE42498OtherHARVARD PILGRIM #
NH7168839OtherCIGNA PROVIDER #
NH800000947Medicaid
NH1861558645OtherNPI, PROVIDER LOCATION
NH1922164797OtherNPI, PROVIDER LOCATION
NH0132510002Medicare NSC
NH0102168Y0NH01OtherANTHEM BCBS PROVIDER #
NH7168839OtherCIGNA PROVIDER #
NH1861558645OtherNPI, PROVIDER LOCATION
NH1922164797OtherNPI, PROVIDER LOCATION
NH0132510004Medicare NSC
NH0132510005Medicare NSC