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General NPI Number Information
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NPI Number | 1063338374
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Entity Type | Individual
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Provider Name | MARCO VIRAY
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Gender | Female
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Dates
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Enumeration Date | 06/29/2026
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Last Update Date | 06/29/2026
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Provider Practice Location Address
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Address Line | 497 MAIN ST FL 1
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-3189
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Country | US
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Telephone | 410-414-3560
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Fax |
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Provider Business Mailing Address
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Address Line | 2417 SHAFER ST
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City | WALDORF
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State | MD
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Zip | 20601-4965
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 30927
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License Number State | MD
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