Provider Demographics
| NPI: | 1437156817 |
|---|---|
| Name: | ANTHONY MARZIANO JR BSC MPT PC |
| Entity Type: | Organization |
| Organization Name: | ANTHONY MARZIANO JR BSC MPT PC |
| Other - Org Name: | PHYSICAL THERAPY PLUS |
| Other - Org Type: | Doing Business As |
| Authorized Official - Title/Position: | OFFICE MANAGER |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | ANTHONY |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | MARZIANO |
| Authorized Official - Suffix: | JR |
| Authorized Official - Credentials: | MPT |
| Authorized Official - Phone: | 610-896-9000 |
| Mailing Address - Street 1: | 1410 MANOA RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WYNNEWOOD |
| Mailing Address - State: | PA |
| Mailing Address - Zip Code: | 19096-3208 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 610-896-9000 |
| Mailing Address - Fax: | 610-896-4385 |
| Practice Address - Street 1: | 1410 MANOA RD |
| Practice Address - Street 2: | |
| Practice Address - City: | WYNNEWOOD |
| Practice Address - State: | PA |
| Practice Address - Zip Code: | 19096-3208 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 610-896-9000 |
| Practice Address - Fax: | 610-896-4385 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2005-06-30 |
| Last Update Date: | 2007-09-13 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| PA | PT006241 | 225100000X |
| PA | PT006241L | 2251C2600X, 2251E1200X, 2251E1300X, 2251G0304X, 2251H1200X, 2251N0400X, 2251P0200X, 2251S0007X, 2251X0800X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Single Specialty | |
| No | 2251C2600X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Cardiopulmonary | Group - Single Specialty |
| No | 2251E1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Ergonomics | Group - Single Specialty |
| No | 2251E1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Electrophysiology, Clinical | Group - Single Specialty |
| No | 2251G0304X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Geriatrics | Group - Single Specialty |
| No | 2251H1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Hand | Group - Single Specialty |
| No | 2251N0400X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology | Group - Single Specialty |
| No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Single Specialty |
| No | 2251S0007X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports | Group - Single Specialty |
| No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | Group - Single Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| PA | 067137 | Medicare ID - Type Unspecified |
