Provider Demographics
NPI:1932162799
Name:MIRARCHI, MARIA NANCY (DC)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:NANCY
Last Name:MIRARCHI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 WOLF ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-2935
Mailing Address - Country:US
Mailing Address - Phone:215-334-2646
Mailing Address - Fax:215-334-2660
Practice Address - Street 1:1333 WOLF ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-2935
Practice Address - Country:US
Practice Address - Phone:215-334-2646
Practice Address - Fax:215-334-2660
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003775L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMI560503Medicare ID - Type Unspecified