Provider Demographics
NPI:1407220114
Name:MARCOTULLI, DANIELLE ELIZABETH (APN)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ELIZABETH
Last Name:MARCOTULLI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 2ND ST STE 240
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2191
Mailing Address - Country:US
Mailing Address - Phone:551-996-3925
Mailing Address - Fax:
Practice Address - Street 1:92 2ND ST STE 3
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2191
Practice Address - Country:US
Practice Address - Phone:519-963-9255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-18
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00587800207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ00587800OtherMEDICAL LICENSE