Provider Demographics
NPI:1003883489
Name:VROBEL, MARIANNE ELIZABETH (PT)
Entity type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:ELIZABETH
Last Name:VROBEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1182 TROY SCHENECTADY RD
Mailing Address - Street 2:SUITE LL02
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-1026
Mailing Address - Country:US
Mailing Address - Phone:518-220-9705
Mailing Address - Fax:518-220-9651
Practice Address - Street 1:1182 TROY SCHENECTADY RD
Practice Address - Street 2:SUITE LL02
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-1026
Practice Address - Country:US
Practice Address - Phone:518-220-9705
Practice Address - Fax:518-220-9651
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0109671225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01700816Medicaid
QQ4002OtherBS
000492257014OtherBS
10002120OtherCDPHP
6008746OtherMVP
10002120OtherCDPHP
6008746OtherMVP