Provider Demographics
NPI:1891943387
Name:DENNINGER, MARJORIE (PT)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:
Last Name:DENNINGER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARJORIE
Other - Middle Name:
Other - Last Name:MATIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:11 EAGLE ROCK AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3101
Mailing Address - Country:US
Mailing Address - Phone:973-887-9000
Mailing Address - Fax:
Practice Address - Street 1:43 OLD BLOOMFIELD AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MOUNTAIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07046-1429
Practice Address - Country:US
Practice Address - Phone:973-402-1600
Practice Address - Fax:973-402-1770
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01288800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ133265Medicare PIN