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NPI Code Detail

MEDICARE: MICHAEL ANTHONY MARCHIONNE BCBA

MEDICARE: MICHAEL ANTHONY MARCHIONNE BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-21-48786NJ

General Provider Information

NPI Number : 1295541167
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ANTHONY MARCHIONNE BCBA
Provider Business Mailing Address
First Line : 45 WINDINGBROOK DR
Second Line :
City : ATCO
State : NJ
Zip : 08004-2904
Country : US
Telephone Number : 856-281-5429
Fax Number :
Provider Business Practice Location Address
First Line : 3000 ATRIUM WAY STE 430
Second Line :
City : MOUNT LAUREL
State : NJ
Zip : 08054-3914
Country : US
Telephone Number : 609-200-0123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2024
Last Update Date : 12/05/2024

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