Basic Information
Provider Information
NPI: 1780840355
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARCHESE
FirstName: RONALD
MiddleName: F
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 100 E PENN SQ
Address2: 9TH FLOOR
City: PHILADELPHIA
State: PA
PostalCode: 191073323
CountryCode: US
TelephoneNumber: 2674259232
FaxNumber: 2674259299
Practice Location
Address1: 3401 CIVIC CENTER BLVD
Address2: CHILDREN'S HOSPITAL OF PHILADELPHIA - EMERGENCY MED
City: PHILADELPHIA
State: PA
PostalCode: 191044319
CountryCode: US
TelephoneNumber: 2155901944
FaxNumber: 2155904454
Other Information
ProviderEnumerationDate: 08/04/2008
LastUpdateDate: 04/16/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XMD442665PAN Allopathic & Osteopathic PhysiciansPediatrics 
2080P0204XMD442665PAY Allopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine

No ID Information.


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