1750775581 NPI number — COURTNEY MARCHETTI, PLLC

Table of content: (NPI 1750775581)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750775581 NPI number — COURTNEY MARCHETTI, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COURTNEY MARCHETTI, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750775581
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 910
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01302-0910
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-655-3603
Provider Business Mailing Address Fax Number:
413-772-8900

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
139 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 703
Provider Business Practice Location Address City Name:
BRATTLEBORO
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05301-3040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-246-0035
Provider Business Practice Location Address Fax Number:
802-246-1003
Provider Enumeration Date:
03/18/2015

Additional Information

Authorized Official

Authorized Official Last Name:
MARCHETTI
Authorized Official First Name:
COURTNEY
Authorized Official Middle Name:
P
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
774-696-4110

Provider Taxonomy Codes

  • Taxonomy code: 163WP0807X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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