Provider Demographics
NPI:1558954453
Name:MARLEY, PILI SHAKEEL JAY (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:PILI SHAKEEL
Middle Name:JAY
Last Name:MARLEY
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 1:12 CINDY LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3305
Mailing Address - Country:US
Mailing Address - Phone:860-830-8545
Mailing Address - Fax:
Practice Address - Street 1:12 CINDY LN
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3305
Practice Address - Country:US
Practice Address - Phone:860-830-8545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12717225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist