Provider Demographics
NPI:1407924095
Name:MARCO, CHRISTA M (APN)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:M
Last Name:MARCO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:468 PARISH DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-4671
Mailing Address - Country:US
Mailing Address - Phone:973-305-8300
Mailing Address - Fax:973-305-8157
Practice Address - Street 1:468 PARISH DR
Practice Address - Street 2:SUITE 6
Practice Address - City:WAYNE
Practice Address - State:NY
Practice Address - Zip Code:07470
Practice Address - Country:US
Practice Address - Phone:973-686-2777
Practice Address - Fax:973-686-2780
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJNJ00093500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily