Individual
JOHNATHAN ANDREW MARASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4000
Mailing address
234 WAYLAND AVE APT 7, PROVIDENCE, RI 02906-4557
(479) 264-7710
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/02/2021
Last updated
07/05/2023
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