Provider Demographics
NPI:1225805880
Name:MARZANO, EMILIE (PT,DPT)
Entity Type:Individual
Prefix:
First Name:EMILIE
Middle Name:
Last Name:MARZANO
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HUNTINGTON QUADRANGLE STE 103N
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4601
Mailing Address - Country:US
Mailing Address - Phone:516-474-2816
Mailing Address - Fax:
Practice Address - Street 1:25503 UNION TPKE
Practice Address - Street 2:
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004-1223
Practice Address - Country:US
Practice Address - Phone:718-928-2790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051674225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist