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NPI Code Detail

MEDICARE: MARIANNE P WHITE

MEDICARE: MARIANNE P WHITE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1063532497
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANNE P WHITE
Provider Business Mailing Address
First Line : PO BOX 1086
Second Line :
City : PLEASANTVILLE
State : NJ
Zip : 08232-6086
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6010 BLACK HORSE PIKE
Second Line :
City : EGG HARBOR TOWNSHIP
State : NJ
Zip : 08234-9752
Country : US
Telephone Number : 609-272-8580
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2007
Last Update Date : 07/08/2007

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