Individual provider Active NPI

Christopher Emmanuel Marquez, PTA

  • Physical Therapy Assistant
  • New Brunswick, NJ
National Provider Identifier
1346917929
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
40QB00387300 Issued in NJ
Practice address
207 Livingston Ave
New Brunswick, NJ 08901
Phone
(908) 503-5384
NPI assigned
Aug 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 40QB00387300 NJ Primary

Addresses

Primary practice location

207 Livingston Ave
New Brunswick, NJ 08901

Mailing address

86 Market St
Perth Amboy, NJ 08861-4410
Phone (732) 423-7233

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

State licenses

LicenseStateTypeSpecialty
40QB00387300NJMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kinesio Lab Physical Therapy LLC Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1346917929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 MARKET ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088614410",
            "telephone_number": "732-423-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 LIVINGSTON AVE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "08901",
            "telephone_number": "908-503-5384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "CHRISTOPHER",
        "middle_name": "EMMANUEL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00387300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.