Katherine Rose Marino, M.D., PH.D.
Individual provider Active NPI Pediatrics Physician · Worcester, MA
NPI 1912326844 · NPPES record last updated Sep 7, 2018
Key facts
- NPI
- 1912326844
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 274666 (MA)
- Practice address
- 123 Summer St
Worcester, MA 01608-1216 - Phone
- (508) 363-9530
- Fax
- (774) 843-5498
- NPI assigned
- Apr 8, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 274666 | MA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Child Health Associates | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- kmarino34098@direct.chppoc.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 274666 | MA | Yes |
Addresses
Primary practice location
123 Summer St
Worcester, MA 01608-1216
Mailing address
119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-1000
Other practice location 1
119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-1000
Other providers in Worcester, MA
- Jennifer L Marine
- Timari Marinelli
- Taysha Marinho Santa
- Alexandra Marino
- Arianna Marino
- Brianna Marion
- Matthew Mariyampillai
- Mark a. Aversa MD PC
- Eddie Kevin Mark
- Joseph Gerard Markeseines
All providers in Worcester, MA · Pediatrics Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.