Provider Demographics
NPI:1326327677
Name:SAFREN, MARLYN COHEN (PT)
Entity Type:Individual
Prefix:
First Name:MARLYN
Middle Name:COHEN
Last Name:SAFREN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARLYN
Other - Middle Name:JOYCE
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:11656 WHITETAIL LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-1436
Mailing Address - Country:US
Mailing Address - Phone:410-531-7137
Mailing Address - Fax:410-531-1783
Practice Address - Street 1:11656 WHITETAIL LN
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042
Practice Address - Country:US
Practice Address - Phone:410-531-7137
Practice Address - Fax:410-531-1783
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15514225100000X, 2251G0304X
2251P0200X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics