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General NPI Number Information
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NPI Number | 1275545600
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Entity Type | Individual
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Provider Name | CATHY MARCHIONDA P.A.-C
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Gender | Female
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 02/28/2018
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Provider Practice Location Address
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Address Line | 706 GREEN BLVD
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City | AURORA
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State | IN
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Zip | 47001-1506
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Country | US
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Telephone | 812-221-1413
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Fax | 812-610-4564
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Provider Business Mailing Address
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Address Line | 706 GREEN BLVD
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City | AURORA
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State | IN
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Zip | 47001-1506
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Country | US
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Telephone | 812-221-1413
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Fax | 812-610-4564
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10000956C
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA437
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10000956A
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License Number State | IN
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