Provider Demographics
NPI:1689255911
Name:SCHEDLER, MARISSA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:SCHEDLER
Suffix:
Gender:F
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 1:2375B NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4258
Mailing Address - Country:US
Mailing Address - Phone:631-673-2933
Mailing Address - Fax:631-673-3086
Practice Address - Street 1:2375B NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-4258
Practice Address - Country:US
Practice Address - Phone:631-673-2933
Practice Address - Fax:631-673-3086
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047021225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist