Provider Demographics
NPI:1538541685
Name:CHIAPPONE, MARCIA
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:CHIAPPONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4481 BUFFALO RD
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14428-9791
Mailing Address - Country:US
Mailing Address - Phone:585-727-3259
Mailing Address - Fax:
Practice Address - Street 1:4481 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:CHURCHVILLE
Practice Address - State:NY
Practice Address - Zip Code:14428-9791
Practice Address - Country:US
Practice Address - Phone:585-727-3259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22325524163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse