Individual
DIANE M. REALI MARINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI 02904-5113
(401) 456-3000
Mailing address
PO BOX 65377, CHARLOTTE, NC 28265-0377
(800) 377-8721
(304) 523-2241
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD08740
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27419-1
BLUECROSS BLUESHIELD
RI
01
—
401700
BLUE CHIP
RI
05
—
7004493
—
RI
01
—
P00171398
RAILROAD
—
Enumeration date
02/22/2006
Last updated
10/04/2022
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