Healthcare Provider Details

I. General information

NPI: 1689768319
Provider Name (Legal Business Name): MARC A ROVITO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 09/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2494 BERNVILLE RD SUITE G-04
READING PA
19605-9469
US

IV. Provider business mailing address

PO BOX 858 A410
HERSHEY PA
17033-0858
US

V. Phone/Fax

Practice location:
  • Phone: 610-378-2117
  • Fax: 610-378-2674
Mailing address:
  • Phone: 800-243-1455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD042375L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: