Provider Demographics
NPI:1467687053
Name:MENENDEZ, MARSHA STABNAU (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:STABNAU
Last Name:MENENDEZ
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 1:1190 BEAUMONT RD
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-2036
Mailing Address - Country:US
Mailing Address - Phone:610-647-4354
Mailing Address - Fax:
Practice Address - Street 1:1615 E BOOT RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-6001
Practice Address - Country:US
Practice Address - Phone:484-653-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA000523E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist