Healthcare Provider Details

I. General information

NPI: 1831068725
Provider Name (Legal Business Name): MARVIN FRANCIS CAJOLES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2025
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 HEWLETT AVE
MERRICK NY
11566-3951
US

IV. Provider business mailing address

70 BELLMORE RD
EAST MEADOW NY
11554-2133
US

V. Phone/Fax

Practice location:
  • Phone: 516-233-9658
  • Fax:
Mailing address:
  • Phone: 516-233-9658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number12310-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: