Provider Demographics
NPI:1073623989
Name:MARQUEZ ROSARION, UGYNNIE GUILLERMO (PT)
Entity Type:Individual
Prefix:MRS
First Name:UGYNNIE
Middle Name:GUILLERMO
Last Name:MARQUEZ ROSARION
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:UGYNNIE
Other - Middle Name:GUILLERMO
Other - Last Name:MARQUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:40-24 76TH STREET
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1004
Mailing Address - Country:US
Mailing Address - Phone:718-205-9020
Mailing Address - Fax:718-205-7030
Practice Address - Street 1:40-24 76TH STREET
Practice Address - Street 2:SUITE 1B
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1004
Practice Address - Country:US
Practice Address - Phone:718-205-9020
Practice Address - Fax:718-205-7030
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40AZ01148800225100000X
NY025651-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist