Provider Demographics
NPI:1063588036
Name:MARX, JOANN (CPO, FAAOP)
Entity type:Individual
Prefix:MS
First Name:JOANN
Middle Name:
Last Name:MARX
Suffix:
Gender:F
Credentials:CPO, FAAOP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1659 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-1415
Mailing Address - Country:US
Mailing Address - Phone:631-563-1881
Mailing Address - Fax:631-563-7237
Practice Address - Street 1:79 MIDDLEVILLE RD
Practice Address - Street 2:PROSTHETIC DEPT. BLD. 200, 4TH FLOOR
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2200
Practice Address - Country:US
Practice Address - Phone:631-754-7936
Practice Address - Fax:631-754-7965
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist