Provider Demographics
NPI:1689615742
Name:MARASCO, DUANE S (DC)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:S
Last Name:MARASCO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3335
Mailing Address - Country:US
Mailing Address - Phone:724-223-9700
Mailing Address - Fax:724-229-7986
Practice Address - Street 1:24 WILSON AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3335
Practice Address - Country:US
Practice Address - Phone:724-223-9700
Practice Address - Fax:724-229-7986
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC2751-L111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101357OtherUPMC/UPMC FOR LIFE/UPMC U
PA1041893Medicaid
PA483607OtherAETNA
PACH134658OtherHIGHMARK BLUE CROSS/BS
PA381191OtherUNITED HEALTHCARE
PA78678Medicaid
PADM382047OtherASHN
PA001116628-0002Medicaid
PA1041893Medicaid
PAT28493Medicare UPIN