Provider Demographics
NPI:1104902212
Name:FLORES, MARIANNE (PT)
Entity type:Individual
Prefix:MRS
First Name:MARIANNE
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARIANNE
Other - Middle Name:
Other - Last Name:ENCARNACION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 UNIVERSITY PLZ STE 205
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-6208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15 VER VALEN ST
Practice Address - Street 2:
Practice Address - City:CLOSTER
Practice Address - State:NJ
Practice Address - Zip Code:07624-2635
Practice Address - Country:US
Practice Address - Phone:201-784-6800
Practice Address - Fax:201-784-6801
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P2986900OtherOXFORD
P2986900OtherOXFORD
066155RB9Medicare PIN