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General NPI Number Information
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NPI Number | 1083939847
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Entity Type | Individual
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Provider Name | MARIE DEMARCO L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 04/05/2010
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Last Update Date | 04/05/2010
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Provider Practice Location Address
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Address Line | 4844 SUNRISE HWY
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City | SAYVILLE
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State | NY
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Zip | 11782-1011
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Country | US
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Telephone | 631-327-2475
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Fax | 631-563-1074
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Provider Business Mailing Address
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Address Line | 332 TERRY BLVD
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City | HOLBROOK
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State | NY
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Zip | 11741-5747
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Country | US
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Telephone | 631-327-4275
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Fax | 631-563-1074
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 023642
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License Number State | NY
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