Healthcare Provider Details
I. General information
NPI: 1114805744
Provider Name (Legal Business Name): PATRICIA M MARRONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/22/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8000 FELLOWSHIP RD
BASKING RIDGE NJ
07920-3915
US
IV. Provider business mailing address
710 NEW YORK AVE
RARITAN NJ
08869-1206
US
V. Phone/Fax
- Phone: 908-340-3313
- Fax: 908-647-3963
- Phone: 908-581-0410
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225200000X |
| Taxonomy | Physical Therapy Assistant |
| License Number | 40QB00236200 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: