Provider Demographics
NPI:1821678418
Name:NACCARATO, MADELEINE ANNE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MADELEINE
Middle Name:ANNE
Last Name:NACCARATO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MADELEINE
Other - Middle Name:ANNE
Other - Last Name:WECHSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:925 CHESTNUT ST STE 320A
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4216
Mailing Address - Country:US
Mailing Address - Phone:215-955-8874
Mailing Address - Fax:215-503-2715
Practice Address - Street 1:925 CHESTNUT ST STE 320A
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4216
Practice Address - Country:US
Practice Address - Phone:215-955-8874
Practice Address - Fax:215-503-2715
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-09
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023268363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner