Provider Demographics
NPI:1922059443
Name:ARCA, MARJORIE J (MD)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:J
Last Name:ARCA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOED AVE- BOX SURG
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-3518
Mailing Address - Country:US
Mailing Address - Phone:585-275-4435
Mailing Address - Fax:585-275-4435
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:PEDIATRIC SURGERY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3518
Practice Address - Country:US
Practice Address - Phone:414-607-5280
Practice Address - Fax:414-266-6579
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2993892086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
005806261COtherHUMANA
WI1922059443Medicaid
WI34383000Medicaid
0054P73601Medicare ID - Type Unspecified
WI34383000Medicaid