Provider Demographics
NPI:1598051492
Name:CHAPNICK, MARISSA S (DPT)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:S
Last Name:CHAPNICK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1310
Mailing Address - Country:US
Mailing Address - Phone:917-509-6776
Mailing Address - Fax:201-644-7586
Practice Address - Street 1:516 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-1310
Practice Address - Country:US
Practice Address - Phone:917-509-6776
Practice Address - Fax:201-644-7586
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010655225100000X
NY031942225100000X
NJ40QA01668600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist