Marina Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

MARINA PHYSICAL THERAPY

Practice address

17515 W 9 Mile Rd Ste 180
Southfield, MI 48075-4400

Phone

(313) 400-0063

NPI assigned

Jul 31, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tarek Charara

Title

Owner

Phone

(313) 400-0063

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564531200000",
    "number": "1043864622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17515 W 9 MILE RD STE 180",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754400",
            "telephone_number": "313-400-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17515 W 9 MILE RD STE 180",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754400",
            "telephone_number": "313-400-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "status": "A",
        "authorized_official_last_name": "CHARARA",
        "authorized_official_first_name": "TAREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-400-0063"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roslyn Kaye Marcy, LPC
• Jeffery C Marderosian, D.D.S.
• Michael J Marderosian, DDS
• Judith Ellen Margerum, PH.D.
• Lynn J Margolis
• Carol Ann Marine
• Alison E Maringo, MD
• Samone Renee Marion, PHD
• Mark R. Morin, D.D.S., P.C.
• Mark S Devore, MD PC

• Physical Therapy Clinic/Center in Southfield, MI
• Providers in Southfield, MI by specialty
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.