Provider Demographics
NPI:1518283902
Name:MARSHALL, JEANNE E (PT)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:E
Last Name:MARSHALL
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 1:1116 BAY AVE
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-3012
Mailing Address - Country:US
Mailing Address - Phone:732-714-1760
Mailing Address - Fax:
Practice Address - Street 1:1506 GULLY RD
Practice Address - Street 2:
Practice Address - City:WALL
Practice Address - State:NJ
Practice Address - Zip Code:07719-4443
Practice Address - Country:US
Practice Address - Phone:732-681-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-11
Last Update Date:2010-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00180000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist