Provider Demographics
NPI:1184653602
Name:SACHETTA, MARIANNE (DPM)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:SACHETTA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2190
Mailing Address - Street 2:
Mailing Address - City:WEST PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-7190
Mailing Address - Country:US
Mailing Address - Phone:781-231-7026
Mailing Address - Fax:
Practice Address - Street 1:380 LOWELL ST
Practice Address - Street 2:SUITE 101B
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-1984
Practice Address - Country:US
Practice Address - Phone:781-224-3668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2185213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA461778OtherTUFTS HEALTH PLAN
MAY71095OtherBLUE CROSS BLUE SHIELD
MA334134OtherHARVARD PILGRIM HEALTHCAR
MA0317187Medicaid
MA0317187Medicaid
MAY71095OtherBLUE CROSS BLUE SHIELD