Provider Demographics
NPI:1184391799
Name:MARCOZZI, GINA A
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:A
Last Name:MARCOZZI
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 1:410 ALMONESSON RD
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-4059
Mailing Address - Country:US
Mailing Address - Phone:856-562-9420
Mailing Address - Fax:
Practice Address - Street 1:800 JESSUP RD
Practice Address - Street 2:
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08086-9354
Practice Address - Country:US
Practice Address - Phone:856-562-9420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist