Individual
MICHAEL J MARINACCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18 ZEPHYR AVE, STATEN ISLAND, NY 10312-5823
(917) 374-1779
Mailing address
18 ZEPHYR AVE, STATEN ISLAND, NY 10312-5823
(917) 374-1779
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/04/2019
Last updated
12/04/2019
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