Provider Demographics
NPI:1396170429
Name:MARZANO, PENNY (OTR)
Entity type:Individual
Prefix:
First Name:PENNY
Middle Name:
Last Name:MARZANO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 TURKEYFOOT RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017-5400
Mailing Address - Country:US
Mailing Address - Phone:855-239-3467
Mailing Address - Fax:
Practice Address - Street 1:2950 TURKEYFOOT RD
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-5400
Practice Address - Country:US
Practice Address - Phone:855-239-3467
Practice Address - Fax:855-239-3467
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY269208225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist