Individual provider Active NPI

Marina De Carvalho Mariz de Oliveira, P.T.

  • Physical Therapist
  • Medford, NY
National Provider Identifier
1114154580
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
031049 Issued in NY
Practice address
81 Pennsylvania Ave
Medford, NY 11763-3717
Phone
(631) 819-1063
NPI assigned
Jun 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 031049 NY Primary

Addresses

Primary practice location

81 Pennsylvania Ave
Medford, NY 11763-3717

Mailing address

81 Pennsylvania Ave FRNT Door
Medford, NY 11763-3717
Phone (631) 819-1063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1114154580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 PENNSYLVANIA AVE FRNT DOOR",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117633717",
            "telephone_number": "631-819-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 PENNSYLVANIA AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117633717",
            "telephone_number": "631-819-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIZ DE OLIVEIRA",
        "first_name": "MARINA",
        "middle_name": "DE CARVALHO",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-12",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; 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.