Healthcare Provider Details

I. General information

NPI: 1396021572
Provider Name (Legal Business Name): JANE D MARFIZO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2011
Last Update Date: 11/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 N 21ST ST
CAMP HILL PA
17011-2204
US

IV. Provider business mailing address

503 N 21ST ST
CAMP HILL PA
17011-2204
US

V. Phone/Fax

Practice location:
  • Phone: 717-763-2219
  • Fax: 717-763-2272
Mailing address:
  • Phone: 717-763-2219
  • Fax: 717-763-2272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: