Provider Demographics
NPI:1508988932
Name:WELCOME, MARCIA
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:WELCOME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25545
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101-7545
Mailing Address - Country:US
Mailing Address - Phone:201-332-0300
Mailing Address - Fax:973-373-1797
Practice Address - Street 1:845 BERGEN AVE
Practice Address - Street 2:SUITE 323
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-4517
Practice Address - Country:US
Practice Address - Phone:201-332-0300
Practice Address - Fax:973-373-1797
Is Sole Proprietor?:No
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor