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Individual

MARK MARINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
301 LAKEHURST RD, TOMS RIVER, NJ 08755-7335
(732) 552-0377
(732) 552-0378
Mailing address
101 2ND ST, LAKEWOOD, NJ 08701-3324
(732) 719-9010
(732) 901-0277

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA06173800
NJ
207V00000X
Obstetrics & Gynecology Physician
NJMA61738
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6559204
NJ
Enumeration date
06/15/2006
Last updated
11/23/2011
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