Healthcare Provider Details

I. General information

NPI: 1437156817
Provider Name (Legal Business Name): ANTHONY MARZIANO JR BSC MPT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 MANOA RD
WYNNEWOOD PA
19096-3208
US

IV. Provider business mailing address

1410 MANOA RD
WYNNEWOOD PA
19096-3208
US

V. Phone/Fax

Practice location:
  • Phone: 610-896-9000
  • Fax: 610-896-4385
Mailing address:
  • Phone: 610-896-9000
  • Fax: 610-896-4385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251C2600X
TaxonomyCardiopulmonary Physical Therapist
License NumberPT006241L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License NumberPT006241L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License NumberPT006241L
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT006241L
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code2251H1200X
TaxonomyHand Physical Therapist
License NumberPT006241L
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License NumberPT006241L
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT006241L
License Number StatePA
# 8
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT006241L
License Number StatePA
# 9
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT006241L
License Number StatePA
# 10
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT006241
License Number StatePA

VIII. Authorized Official

Name: MR. ANTHONY MARZIANO JR.
Title or Position: OFFICE MANAGER
Credential: MPT
Phone: 610-896-9000