Provider Demographics
NPI:1598954679
Name:MARMAROU, JOHN T (DPT, MSCS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:MARMAROU
Suffix:
Gender:M
Credentials:DPT, MSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 BEAR HILL RD STE 105
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1063
Mailing Address - Country:US
Mailing Address - Phone:609-202-5353
Mailing Address - Fax:781-895-4800
Practice Address - Street 1:179 BEAR HILL RD STE 105
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1063
Practice Address - Country:US
Practice Address - Phone:609-202-5353
Practice Address - Fax:781-895-4800
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA011463002251N0400X
MA211262251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology