Individual
LOUIS J. MARINO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6200
(401) 455-6309
Mailing address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6200
(401) 455-6309
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MD09220
RI
2084P0805X
Geriatric Psychiatry Physician
Primary
MD09220
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093831646
BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE NPI
—
01
—
1104801349
BUTLER HOSPITAL NPI
—
01
—
15-37842
UNITED BEHAVIORAL HEALTH
RI
01
—
25185-7
BLUE CROSS
RI
01
—
400061
BLUE CHIP
RI
05
—
9025185
—
RI
Enumeration date
07/28/2006
Last updated
05/06/2008
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