Healthcare Provider Details

I. General information

NPI: 1922658368
Provider Name (Legal Business Name): PAULINE RINA DENISE MARQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2019
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 HOLT DR
STONY POINT NY
10980-1919
US

IV. Provider business mailing address

11 HOLT DR
STONY POINT NY
10980-1919
US

V. Phone/Fax

Practice location:
  • Phone: 845-942-4355
  • Fax:
Mailing address:
  • Phone: 845-942-4355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number046065
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: