MEDICARE: MS. SHIRLEY AFONSO MARSHALL DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	25949	MD
2	225100000X	Physical Therapist	038380	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801339098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHIRLEY AFONSO MARSHALL DPT

Provider Business Mailing Address
First Line	:	3163 35TH ST APT 1R
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11106-1574
Country	:	US
Telephone Number	:	929-393-4406
Fax Number	:

Provider Business Practice Location Address
First Line	:	3529 82ND STREET
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372
Country	:	US
Telephone Number	:	718-307-5750
Fax Number	:	718-205-0178

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2016
Last Update Date	:	04/10/2026

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