Provider Demographics
NPI:1922068337
Name:MARLBORO PHYSICAL THERAPY, PA
Entity Type:Organization
Organization Name:MARLBORO PHYSICAL THERAPY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FUHRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-591-9494
Mailing Address - Street 1:100 CAMPUS DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1282
Mailing Address - Country:US
Mailing Address - Phone:732-591-9494
Mailing Address - Fax:732-591-8850
Practice Address - Street 1:100 CAMPUS DR
Practice Address - Street 2:SUITE 102
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1282
Practice Address - Country:US
Practice Address - Phone:732-591-9494
Practice Address - Fax:732-591-8850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ037048Medicare PIN
NJ037048Medicare PIN