Marc Corres Estacio

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

40QB00410400 Issued in NJ

Practice address

185 N Rte 17 Ste 101B
Paramus, NJ 07652-2963

Phone

(201) 584-4509

NPI assigned

Oct 31, 2023

Last updated

Oct 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1427821610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HAMILTON AVE",
            "city": "DUMONT",
            "state": "NJ",
            "postal_code": "076282003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 N RTE 17 STE 101B",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522963",
            "telephone_number": "201-584-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTACIO",
        "first_name": "MARC",
        "middle_name": "CORRES",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00410400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Franklin Erzuah, NURSE PRACTITIONER
• Ma Julianne Francesca Esguerra, MD
• Kenneth Ira Eskow, O.D.
• Leslie J. Esmail, APN
• Paige Espinal
• Amir Estephan, M.D.
• Evelyn Estevez, PTA
• Frances Z Estrada, APN
• Ulyses Favian Estrada, DC
• Eton Medical Group, PA (Bergen Family Practice)

• Physical Therapy Assistant in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Physical Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.