Mary Katherine Marzano, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3199-024 Issued in WI

Practice address

15350 W National Ave
Suite #109
New Berlin, WI 53151-5158

Phone

(262) 789-0970

Fax

(262) 789-7817

NPI assigned

Jul 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770508764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 N 86TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532222829",
            "telephone_number": "414-463-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15350 W NATIONAL AVE",
            "address_2": "SUITE #109",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531515158",
            "telephone_number": "262-789-0970",
            "fax_number": "262-789-7817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZANO",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3199-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36126500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in New Berlin, WI
• Providers in New Berlin, WI by specialty
• Physical Therapist in Wisconsin

• 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.