Provider Demographics
NPI:1831115443
Name:MARINO, IGNAZIO R (MD)
Entity type:Individual
Prefix:DR
First Name:IGNAZIO
Middle Name:R
Last Name:MARINO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:615 CHESTNUT ST
Mailing Address - Street 2:14TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-4404
Mailing Address - Country:US
Mailing Address - Phone:215-955-1175
Mailing Address - Fax:215-955-2420
Practice Address - Street 1:1100 WALNUT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5563
Practice Address - Country:US
Practice Address - Phone:215-955-6750
Practice Address - Fax:215-923-8222
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD045804L204F00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgery