Provider Demographics
NPI:1184829905
Name:MARSOCCI, NINETTE HELENE (DC)
Entity Type:Individual
Prefix:DR
First Name:NINETTE
Middle Name:HELENE
Last Name:MARSOCCI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 RANDOLPH RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-2034
Mailing Address - Country:US
Mailing Address - Phone:704-362-3305
Mailing Address - Fax:704-362-3314
Practice Address - Street 1:2711 RANDOLPH RD STE 203
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2027
Practice Address - Country:US
Practice Address - Phone:704-362-3305
Practice Address - Fax:704-362-3314
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3761111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2456067Medicare PIN