Provider Demographics
NPI:1144946096
Name:MARKIZON, CARLA N
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:N
Last Name:MARKIZON
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 1:299 WESTBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-2539
Mailing Address - Country:US
Mailing Address - Phone:610-357-6637
Mailing Address - Fax:
Practice Address - Street 1:851 ROUTE 73 N STE C
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-1275
Practice Address - Country:US
Practice Address - Phone:856-872-2067
Practice Address - Fax:877-275-5941
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00676600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist