Provider Demographics
NPI:1619110293
Name:MARSHALL, ANNE (PT)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
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 1:4 CORNWALL DR STE 220
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3332
Mailing Address - Country:US
Mailing Address - Phone:732-257-0900
Mailing Address - Fax:732-257-5099
Practice Address - Street 1:4 CORNWALL DR STE 220
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3332
Practice Address - Country:US
Practice Address - Phone:732-257-0900
Practice Address - Fax:732-257-5099
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01139700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist