1659695955 NPI number — DR. FERNANDA D. MARCHI D.D.S.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659695955 NPI number — DR. FERNANDA D. MARCHI D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARCHI
Provider First Name:
FERNANDA
Provider Middle Name:
D.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RUDY
Provider Other First Name:
FERNANDA
Provider Other Middle Name:
MARCHI
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.D.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1659695955
Entity Type Code:
Individual
Replacement NPI:
1659695955
Last Update Date:
02/07/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/03/2010
NPI Reactivation Date:
03/16/2010

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1275 POST RD
Provider Second Line Business Mailing Address:
SUITE 211
Provider Business Mailing Address City Name:
FAIRFIELD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06824-6015
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-292-6644
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1275 POST RD
Provider Second Line Business Practice Location Address:
SUITE 211
Provider Business Practice Location Address City Name:
FAIRFIELD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06824-6015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-292-6644
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/25/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X , with the licence number:  049007 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223X0400X , with the licence number: 008784 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)