Provider Demographics
NPI:1518295369
Name:NICHOLAS A. MARCHESE, M.D.P.A.
Entity Type:Organization
Organization Name:NICHOLAS A. MARCHESE, M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MARCHESE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-865-8630
Mailing Address - Street 1:2002 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-4431
Mailing Address - Country:US
Mailing Address - Phone:201-865-8630
Mailing Address - Fax:201-865-3867
Practice Address - Street 1:2002 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-4431
Practice Address - Country:US
Practice Address - Phone:201-865-8630
Practice Address - Fax:201-865-3867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-04
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0173172084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ139353Medicare PIN