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NPI Code Detail

MEDICARE: MARIAN H WADE PT

MEDICARE:   MARIAN H WADE  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist013256-1NY

General Provider Information

NPI Number : 1306091269
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIAN H WADE PT
Provider Business Mailing Address
First Line : 50 MORNINGSIDE DR
Second Line : #32
City : NEW YORK
State : NY
Zip : 10025-1756
Country : US
Telephone Number : 212-866-0648
Fax Number :
Provider Business Practice Location Address
First Line : 50 MORNINGSIDE DR
Second Line : #32
City : NEW YORK
State : NY
Zip : 10025-1739
Country : US
Telephone Number : 212-866-0648
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2008
Last Update Date : 12/06/2011

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Directions to “ MARIAN H WADE PT” Practice Location

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