Individual
MARCIE BASILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103-6202
(610) 402-8111
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA052285
PA
Other
Enumeration date
07/01/2006
Last updated
12/17/2015
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