Healthcare Provider Details

I. General information

NPI: 1932596749
Provider Name (Legal Business Name): NICOLE MARCHETTO MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2015
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 CHESTERBROOK BLVD
CHESTERBROOK PA
19087-5638
US

IV. Provider business mailing address

9600 BLACKWELL RD STE 500
ROCKVILLE MD
20850-3783
US

V. Phone/Fax

Practice location:
  • Phone: 610-981-6000
  • Fax: 855-437-5785
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberC1-0025136
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberMD478345
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: