Provider Demographics
NPI: | 1528094927 |
---|---|
Name: | CZAPLICKI-MARGIOTTI, MARIE ANN (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | MARIE |
Middle Name: | ANN |
Last Name: | CZAPLICKI-MARGIOTTI |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 350 SPARTA AVE |
Mailing Address - Street 2: | C-7 |
Mailing Address - City: | SPARTA |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 07871-1120 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 973-729-1113 |
Mailing Address - Fax: | 570-409-1106 |
Practice Address - Street 1: | 350 SPARTA AVE |
Practice Address - Street 2: | C-7 |
Practice Address - City: | SPARTA |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 07871-1120 |
Practice Address - Country: | US |
Practice Address - Phone: | 973-940-8100 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2006-06-25 |
Last Update Date: | 2013-04-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | MD418845 | 207X00000X |
NJ | 25MA03065800 | 207X00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | 001888189 | Medicaid | |
NJ | 057090ZDQT | Medicare PIN | |
PA | 001888189 | Medicaid | |
PA | 057090 | Medicare ID - Type Unspecified | MEDICARE |
NJ | 456050ZDCF | Medicare PIN |