Provider Demographics
NPI:1770468365
Name:MARCKETTA, LORRAINE ANNE
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:ANNE
Last Name:MARCKETTA
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 1:453B CHESHIRE CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-7837
Mailing Address - Country:US
Mailing Address - Phone:908-577-8977
Mailing Address - Fax:
Practice Address - Street 1:453B CHESHIRE CT
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-7837
Practice Address - Country:US
Practice Address - Phone:908-577-8977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty