Healthcare Provider Details

I. General information

NPI: 1619830213
Provider Name (Legal Business Name): MARCIE'S MOVEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 MARGIASSO CT
RIVER VALE NJ
07675-6100
US

IV. Provider business mailing address

431 MARGIASSO CT
RIVER VALE NJ
07675-6100
US

V. Phone/Fax

Practice location:
  • Phone: 201-424-2502
  • Fax:
Mailing address:
  • Phone: 201-424-2502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number State

VIII. Authorized Official

Name: ALISA JACOBSON
Title or Position: OWNER
Credential:
Phone: 201-424-2502