Healthcare Provider Details

I. General information

NPI: 1144978826
Provider Name (Legal Business Name): MARCI PAMBIANCHI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2022
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4553 FOXTAIL DR
NAZARETH PA
18064-9666
US

IV. Provider business mailing address

4553 FOXTAIL DR
NAZARETH PA
18064-9666
US

V. Phone/Fax

Practice location:
  • Phone: 484-560-1695
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARCI PAMBIANCHI
Title or Position: PROFESSIONAL COUNSELOR
Credential:
Phone: 484-207-0443