Healthcare Provider Details

I. General information

NPI: 1952729964
Provider Name (Legal Business Name): DR. JOSEPH ANTHONY MARASCIO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 09/08/2021
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BOWMAN DR STE 190
VOORHEES NJ
08043-9623
US

IV. Provider business mailing address

52 E MAIN ST APT 302
MARLTON NJ
08053-2141
US

V. Phone/Fax

Practice location:
  • Phone: 568-247-7330
  • Fax:
Mailing address:
  • Phone: 610-999-2619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD475020
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number83184
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number25MA11182000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: