Provider Demographics
NPI:1053114637
Name:MARINO, NINO S III
Entity type:Individual
Prefix:
First Name:NINO
Middle Name:S
Last Name:MARINO
Suffix:III
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 KNESEL ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-1701
Mailing Address - Country:US
Mailing Address - Phone:347-299-8750
Mailing Address - Fax:
Practice Address - Street 1:41 KNESEL ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-1701
Practice Address - Country:US
Practice Address - Phone:347-299-8750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency