MEDICARE: JAMES J MARCIN D.O.

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
1	207RP1001X	Pulmonary Disease Physician	OS009547L	PA

General Provider Information

NPI Number	:	1457353401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES J MARCIN D.O.

Provider Business Mailing Address
First Line	:	752 BROOKSHIRE DR
Second Line	:	STE 3
City	:	HERMITAGE
State	:	PA
Zip	:	16148-4510
Country	:	US
Telephone Number	:	724-347-5864
Fax Number	:	724-346-6104

Provider Business Practice Location Address
First Line	:	752 BROOKSHIRE DR
Second Line	:	STE 3
City	:	HERMITAGE
State	:	PA
Zip	:	16148-4510
Country	:	US
Telephone Number	:	724-347-5864
Fax Number	:	724-346-6104

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	07/02/2010

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