Provider Demographics
NPI:1497916225
Name:MACRI, MARCIA JO (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:JO
Last Name:MACRI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S MERCER ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-3849
Mailing Address - Country:US
Mailing Address - Phone:724-658-8515
Mailing Address - Fax:
Practice Address - Street 1:101 S MERCER ST
Practice Address - Street 2:SUITE 306
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-3849
Practice Address - Country:US
Practice Address - Phone:724-658-8515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001036L171W00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001885169Medicaid