Provider Demographics
NPI:1598186165
Name:SENIC- MARQUES, MASHA (DPT)
Entity Type:Individual
Prefix:
First Name:MASHA
Middle Name:
Last Name:SENIC- MARQUES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MASHA
Other - Middle Name:
Other - Last Name:SENIC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:200 QUEBEC ST STE 215
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7144
Mailing Address - Country:US
Mailing Address - Phone:303-341-0369
Mailing Address - Fax:303-341-0866
Practice Address - Street 1:200 QUEBEC ST STE 215
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7144
Practice Address - Country:US
Practice Address - Phone:303-341-0369
Practice Address - Fax:303-341-0866
Is Sole Proprietor?:No
Enumeration Date:2013-12-26
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037028225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400139938Medicare PIN