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General NPI Number Information
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NPI Number | 1184058364
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Entity Type | Individual
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Provider Name | MARCELINA DAMASO ACNP, BC
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Gender | Female
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Dates
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Enumeration Date | 08/24/2013
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Last Update Date | 11/24/2015
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Provider Practice Location Address
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Address Line | 3039 FOULK RD
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City | GARNET VALLEY
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State | PA
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Zip | 19060-1701
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Country | US
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Telephone | 610-361-0070
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Fax | 610-361-0071
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Provider Business Mailing Address
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Address Line | 2377 HAVERFORD RD 2ND FLOOR
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City | ARDMORE
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State | PA
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Zip | 19003-2912
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Country | US
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Telephone | 239-822-9046
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | F430741-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | SP013827
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License Number State | PA
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