Provider Demographics
NPI:1871530881
Name:MARINI, STEVEN G (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:G
Last Name:MARINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4008
Mailing Address - Country:US
Mailing Address - Phone:718-499-6099
Mailing Address - Fax:718-499-6391
Practice Address - Street 1:362 9TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4008
Practice Address - Country:US
Practice Address - Phone:718-499-6099
Practice Address - Fax:718-499-6391
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179173208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01970947Medicaid
F38830Medicare UPIN
NY88K652Medicare PIN