Provider Demographics
NPI:1952810418
Name:MARINO, MARIANNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:
Last Name:MARINO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 CRABAPPLE RD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-1710
Mailing Address - Country:US
Mailing Address - Phone:917-715-1712
Mailing Address - Fax:
Practice Address - Street 1:225 FOREST AVE
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2028
Practice Address - Country:US
Practice Address - Phone:516-759-1201
Practice Address - Fax:516-759-7861
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063513183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist