Provider Demographics
NPI:1295844348
Name:MARCELLI, ENRICO A (DO)
Entity Type:Individual
Prefix:DR
First Name:ENRICO
Middle Name:A
Last Name:MARCELLI
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:4 EVES DR # A
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3195
Mailing Address - Country:US
Mailing Address - Phone:609-267-9400
Mailing Address - Fax:609-267-9457
Practice Address - Street 1:570 EGG HARBOR RD
Practice Address - Street 2:SUITE C-4
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2359
Practice Address - Country:US
Practice Address - Phone:609-267-9400
Practice Address - Fax:609-267-9457
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-02-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMB41230207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ443495Medicare PIN
NJE60562Medicare UPIN