Provider Demographics
NPI:1174642052
Name:MARREN, MAUREEN M (PT)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:M
Last Name:MARREN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 STUYVESANT OVAL APT 10B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2012
Mailing Address - Country:US
Mailing Address - Phone:212-777-3655
Mailing Address - Fax:
Practice Address - Street 1:15 STUYVESANT OVAL APT 10B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-2012
Practice Address - Country:US
Practice Address - Phone:212-777-3655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014542225100000X, 225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner