1790754661 NPI number — JACK MARCHESCHI PHYSICAL THERAPY, P.C.

Table of content: (NPI 1790754661)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790754661 NPI number — JACK MARCHESCHI PHYSICAL THERAPY, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JACK MARCHESCHI PHYSICAL THERAPY, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790754661
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
75 MAIDEN LN
Provider Second Line Business Mailing Address:
SUITE 801
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10038-4810
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-312-6221
Provider Business Mailing Address Fax Number:
212-269-2905

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 WORLD FINANCIAL CTR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10281-1008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-312-6221
Provider Business Practice Location Address Fax Number:
212-269-2905
Provider Enumeration Date:
03/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MARCHESCHI
Authorized Official First Name:
JACK
Authorized Official Middle Name:
ANTHONY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
646-312-6221

Provider Taxonomy Codes

  • Taxonomy code: 2251X0800X , with the licence number:  006615-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com