Provider Demographics
NPI:1861250540
Name:OANCEA, MARIN
Entity type:Individual
Prefix:
First Name:MARIN
Middle Name:
Last Name:OANCEA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 W VIA MONTOYA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-1605
Mailing Address - Country:US
Mailing Address - Phone:623-792-4282
Mailing Address - Fax:
Practice Address - Street 1:3103 W VIA MONTOYA DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-1605
Practice Address - Country:US
Practice Address - Phone:623-792-4282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL10469376K00000X, 310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No376K00000XNursing Service Related ProvidersNurse's Aide