Provider Demographics
NPI:1700605888
Name:DIBUCCI, MARCO (PA)
Entity type:Individual
Prefix:
First Name:MARCO
Middle Name:
Last Name:DIBUCCI
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KNOWLSON AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1634
Mailing Address - Country:US
Mailing Address - Phone:724-581-5301
Mailing Address - Fax:724-891-2734
Practice Address - Street 1:100 KNOWLSON AVE
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1634
Practice Address - Country:US
Practice Address - Phone:724-581-5301
Practice Address - Fax:724-891-2734
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical