Individual provider Active NPI

Marielle Grace Austin, D.P.T.

  • Physical Therapist
  • Middle Island, NY
National Provider Identifier
1184954174
Registry record updated Jan 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
032324 Issued in NY
Practice address
35 Longwood Rd
Middle Island, NY 11953-2045
Phone
(631) 924-0008
NPI assigned
Jan 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2010

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 032324 NY Primary

Addresses

Primary practice location

35 Longwood Rd
Middle Island, NY 11953-2045

Mailing address

1380 Boston Ave
Bay Shore, NY 11706-4752
Phone (631) 793-6022

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263340800000",
    "number": "1184954174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 BOSTON AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064752",
            "telephone_number": "631-793-6022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 LONGWOOD RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532045",
            "telephone_number": "631-924-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSTIN",
        "first_name": "MARIELLE",
        "middle_name": "GRACE",
        "name_prefix": "Miss",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-13",
        "last_updated": "2010-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; 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.