Provider Demographics
NPI:1801929427
Name:MARSALA, ANTHONY R (PT, MPT, ATC)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:R
Last Name:MARSALA
Suffix:
Gender:M
Credentials:PT, MPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 ELM AVE APT 20
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-4517
Mailing Address - Country:US
Mailing Address - Phone:516-672-2923
Mailing Address - Fax:
Practice Address - Street 1:1641 ELM AVE APT 20
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742
Practice Address - Country:US
Practice Address - Phone:516-672-2923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029203225100000X
NJ40QA01264800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist