Provider Demographics
NPI:1790754661
Name:JACK MARCHESCHI PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:JACK MARCHESCHI PHYSICAL THERAPY, P.C.
Other - Org Name:PLUS ONE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MARCHESCHI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:646-312-6221
Mailing Address - Street 1:75 MAIDEN LN
Mailing Address - Street 2:SUITE 801
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4810
Mailing Address - Country:US
Mailing Address - Phone:646-312-6221
Mailing Address - Fax:212-269-2905
Practice Address - Street 1:2 WORLD FINANCIAL CTR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10281-1008
Practice Address - Country:US
Practice Address - Phone:646-312-6221
Practice Address - Fax:212-269-2905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006615-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty