Provider Demographics
NPI:1609608827
Name:MARIANI, MARISA NICOLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:NICOLE
Last Name:MARIANI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 BANK ST APT 203D
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-7001
Mailing Address - Country:US
Mailing Address - Phone:914-552-4597
Mailing Address - Fax:
Practice Address - Street 1:672 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5008
Practice Address - Country:US
Practice Address - Phone:914-722-2400
Practice Address - Fax:914-722-2406
Is Sole Proprietor?:No
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053033225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist