Provider Demographics
NPI:1437179504
Name:MARZULLI, KAREN ANN (LPT)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ANN
Last Name:MARZULLI
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1862 BOAT POINT DR
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-5223
Mailing Address - Country:US
Mailing Address - Phone:732-996-4364
Mailing Address - Fax:
Practice Address - Street 1:2164 HIGWAY 35
Practice Address - Street 2:BLD C
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750
Practice Address - Country:US
Practice Address - Phone:732-974-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQAO3006225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ589517Medicare ID - Type Unspecified