Provider Demographics
NPI:1801955745
Name:MARECKI, MARSHA (NP)
Entity type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:
Last Name:MARECKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 DORSET DR
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-1730
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2697 MAIN ST
Practice Address - Street 2:PLANNED PARENTHOOD
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-1701
Practice Address - Country:US
Practice Address - Phone:716-831-2200
Practice Address - Fax:716-831-8836
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF4201241363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000560235003OtherBCBS
NY000560235003OtherBCBS
NY13047DMedicare ID - Type Unspecified