Provider Demographics
NPI:1720374424
Name:DEMARCO, ELVIRA J
Entity Type:Individual
Prefix:MS
First Name:ELVIRA
Middle Name:J
Last Name:DEMARCO
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 1:247 LITTLE POND COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-2800
Mailing Address - Country:US
Mailing Address - Phone:401-334-9821
Mailing Address - Fax:
Practice Address - Street 1:247 LITTLE POND COUNTY RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-2800
Practice Address - Country:US
Practice Address - Phone:401-334-9821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00497101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health