Provider Demographics
NPI:1326325267
Name:WORENKLEIN, MARION TOBI (PT)
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:TOBI
Last Name:WORENKLEIN
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 1:315 W 106TH ST
Mailing Address - Street 2:APT 1 B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3445
Mailing Address - Country:US
Mailing Address - Phone:917-715-3633
Mailing Address - Fax:
Practice Address - Street 1:315 W 106TH ST
Practice Address - Street 2:APT 1 B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-3445
Practice Address - Country:US
Practice Address - Phone:917-715-3633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003183-12251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics