Provider Demographics
NPI:1205963089
Name:STRILECKIS, MARC PAUL (ATC, CSCS)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:PAUL
Last Name:STRILECKIS
Suffix:
Gender:M
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 SHERWOOD PL
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-5638
Mailing Address - Country:US
Mailing Address - Phone:203-869-5169
Mailing Address - Fax:
Practice Address - Street 1:1252 KING ST
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-2938
Practice Address - Country:US
Practice Address - Phone:203-625-5867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0001002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer