Provider Demographics
NPI:1275191108
Name:CARVER, MARGUERITE CARMELA (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:CARMELA
Last Name:CARVER
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 LENAPE TRL
Mailing Address - Street 2:
Mailing Address - City:LONG POND
Mailing Address - State:PA
Mailing Address - Zip Code:18334-8033
Mailing Address - Country:US
Mailing Address - Phone:570-972-9187
Mailing Address - Fax:
Practice Address - Street 1:200 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-2956
Practice Address - Country:US
Practice Address - Phone:570-972-9187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0056522255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty