Individual provider Active NPI

Joan Marciniak, PT

  • Physical Therapist
  • Cherry Hill, NJ
National Provider Identifier
1619321338
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00447200 Issued in NJ
Practice address
1020 Kings Hwy N
Suite 108
Cherry Hill, NJ 08034-1906
Phone
(856) 330-4360
Fax
(856) 330-4281
NPI assigned
Apr 19, 2016
Last updated
Apr 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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 40QA00447200 NJ Primary

Addresses

Primary practice location

1020 Kings Hwy N
Suite 108
Cherry Hill, NJ 08034-1906

Mailing address

1020 Kings Hwy N
Suite 108
Cherry Hill, NJ 08034-1906
Phone (856) 330-4360

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

State licenses

LicenseStateTypeSpecialty
40QA00447200NJMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1619321338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 KINGS HWY N",
            "address_2": "SUITE 108",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341906",
            "telephone_number": "856-330-4360",
            "fax_number": "856-330-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 KINGS HWY N",
            "address_2": "SUITE 108",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341906",
            "telephone_number": "856-330-4360",
            "fax_number": "856-330-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCINIAK",
        "first_name": "JOAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-19",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00447200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.