Individual provider · Type 1 NPI
Marisa C. Randazzo
Primary Care Nurse Practitioner · Philadelphia, PA
NPI number
1730983792
Active
Practice location
3400 Spruce St
Philadelphia, PA 19104-4238
Mailing address
2113 Carpenter St Apt A
Philadelphia, PA 19146-2526
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | SP031541 (PA) |
| Primary Care Nurse Practitioner Primary | 363LP2300X | SP031541 (PA) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1730983792
Marisa C. Randazzo's National Provider Identifier is 1730983792, issued on Apr 1, 2025. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Philadelphia, PA. The record was last updated on Apr 1, 2025.