MEDICARE: JACK MARMORSTEIN APC

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
1	101YP2500X	Professional Counselor	APC000834	PA

General Provider Information

NPI Number	:	1700678760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACK MARMORSTEIN APC

Provider Business Mailing Address
First Line	:	2315 MADISON SQ
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-1712
Country	:	US
Telephone Number	:	540-560-9597
Fax Number	:

Provider Business Practice Location Address
First Line	:	2315 MADISON SQ
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-1712
Country	:	US
Telephone Number	:	540-560-9597
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2025
Last Update Date	:	05/19/2025

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