Provider Demographics
NPI:1285379644
Name:TIME TO FEEL MARVELOUS
Entity type:Organization
Organization Name:TIME TO FEEL MARVELOUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARVELYN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:TIZIANI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:732-702-0970
Mailing Address - Street 1:1294 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:LINCROFT
Mailing Address - State:NJ
Mailing Address - Zip Code:07738-1263
Mailing Address - Country:US
Mailing Address - Phone:732-702-0970
Mailing Address - Fax:
Practice Address - Street 1:1029 SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-3186
Practice Address - Country:US
Practice Address - Phone:732-702-0970
Practice Address - Fax:732-702-0972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-30
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1295309813OtherMEDICARE NPI