Provider Demographics
NPI:1932596749
Name:MARCHETTO, NICOLE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:
Last Name:MARCHETTO
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 CHESTERBROOK BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESTERBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19087-5614
Mailing Address - Country:US
Mailing Address - Phone:610-981-6000
Mailing Address - Fax:
Practice Address - Street 1:205 GRANITE RUN DR STE 350
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6821
Practice Address - Country:US
Practice Address - Phone:610-376-1229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0025136207V00000X
PAMD478345207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology