Marc P Wahl, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

019081 Issued in NY

Practice address

31 Main Rd
Suite 4
Riverhead, NY 11901-1953

Phone

(631) 208-2900

NPI assigned

Jan 6, 2007

Sex

Male

Sole proprietor

No

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)

Enrolled

Practice roles

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.

• North Fork Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Riverhead, NY
  • NPI 1972655041

  Physical Therapist

  NPD (past) Authorized official

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477601649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 MAIN RD",
            "address_2": "SUITE 4",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119011953",
            "telephone_number": "631-208-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 MAIN RD",
            "address_2": "SUITE 4",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119011953",
            "telephone_number": "631-208-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHL",
        "first_name": "MARC",
        "middle_name": "P",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "019081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Vinski, PH.D.
• Lisa Visentin, M.D.
• Mary Alice Visnefsky, RN
• Alicia Vivona, RN, PMHNP
• Vincent James Vona, PHARM D
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Antonio Delano Walcott Jr., MHC-LP
• Walgreen Co
• Christie Marie Walker

• Physical Therapist in Riverhead, NY
• Providers in Riverhead, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.