Active NPI
Marilyn A Mackie, PT
- Physical Therapist
- Riverhead, NY
National Provider Identifier
1619339389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 020850-1
- Practice address
- 278 Horton Ave
Riverhead, NY 11901-1308 - Phone
- (631) 369-8447
- NPI assigned
- Mar 22, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 020850-1 | NY | Primary |
Addresses
Primary practice location
278 Horton Ave
Riverhead, NY 11901-1308
Mailing address
PO Box 352
Remsenburg, NY 11960-0352
Phone (631) 655-6304
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
| License | State | Type | Specialty |
|---|---|---|---|
| 020850 | NY | MD | Clinical Psychologist |
| 020850-1 | NY | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458604800000",
"number": "1619339389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 352",
"city": "REMSENBURG",
"state": "NY",
"postal_code": "119600352",
"telephone_number": "631-655-6304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "278 HORTON AVE",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "119011308",
"telephone_number": "631-369-8447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKIE",
"first_name": "MARILYN",
"middle_name": "A",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-22",
"last_updated": "2016-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "020850-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverhead, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.