Provider Demographics
NPI:1972185221
Name:MARX, MATTHEW D (DNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:D
Last Name:MARX
Suffix:
Gender:M
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 W TOWNSHIP LINE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-4930
Mailing Address - Country:US
Mailing Address - Phone:610-601-0760
Mailing Address - Fax:610-756-0670
Practice Address - Street 1:1120 W TOWNSHIP LINE RD STE 300
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-4930
Practice Address - Country:US
Practice Address - Phone:610-601-0760
Practice Address - Fax:610-756-0670
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP211224363L00000X
PASP025538363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner