Provider Demographics
NPI:1689889719
Name:MARGHELLA, JENNIFER (PTA)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:MARGHELLA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 IONIA AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-3553
Mailing Address - Country:US
Mailing Address - Phone:718-317-2145
Mailing Address - Fax:
Practice Address - Street 1:ONWARD HEALTHCARE 350 FIFTH AVENUE
Practice Address - Street 2:SUITE 5115
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10118
Practice Address - Country:US
Practice Address - Phone:866-601-6474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003292-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant