Provider Demographics
NPI:1750965349
Name:BURCHETTE, MARISSA KAY (MD)
Entity type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:KAY
Last Name:BURCHETTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARISSA
Other - Middle Name:KAY
Other - Last Name:BARE BURCHETTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:936 HUMMEL AVE
Mailing Address - Street 2:
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1737
Mailing Address - Country:US
Mailing Address - Phone:336-848-2363
Mailing Address - Fax:
Practice Address - Street 1:111 S FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-2010
Practice Address - Country:US
Practice Address - Phone:717-782-3131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-10
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program