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General NPI Number Information
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NPI Number | 1144946096
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Entity Type | Individual
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Provider Name | CARLA N MARKIZON
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Gender | Female
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Dates
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Enumeration Date | 10/12/2022
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 851 ROUTE 73 N STE C
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City | MARLTON
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State | NJ
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Zip | 08053-1275
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Country | US
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Telephone | 856-872-2067
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Fax | 877-275-5941
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Provider Business Mailing Address
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Address Line | 299 WESTBROOK DR
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City | SWEDESBORO
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State | NJ
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Zip | 08085-2539
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Country | US
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Telephone | 610-357-6637
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 46TR00676600
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License Number State | NJ
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