Provider Demographics
NPI:1366828717
Name:MARMO, DANIEL EDWARD (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:EDWARD
Last Name:MARMO
Suffix:
Gender:M
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 1:1983 MARCUS AVE
Mailing Address - Street 2:SUITE 119
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-2000
Mailing Address - Country:US
Mailing Address - Phone:516-321-7802
Mailing Address - Fax:
Practice Address - Street 1:200 BOUNDARY AVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-1152
Practice Address - Country:US
Practice Address - Phone:516-249-3760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-08
Last Update Date:2015-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0391242251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic