Provider Demographics
NPI:1699701037
Name:PALLOP, MARCIA NEIBERG (MPT ATC)
Entity type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:NEIBERG
Last Name:PALLOP
Suffix:
Gender:F
Credentials:MPT ATC
Other - Prefix:
Other - First Name:MARCIA
Other - Middle Name:WENDY
Other - Last Name:NEIBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT ATC
Mailing Address - Street 1:1650 LYNDON FARM CT STE 300
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5005
Mailing Address - Country:US
Mailing Address - Phone:856-677-4000
Mailing Address - Fax:856-234-3014
Practice Address - Street 1:1224 TILTON RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1809
Practice Address - Country:US
Practice Address - Phone:609-926-1161
Practice Address - Fax:609-926-3223
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJQA04850225100000X
NJ40QA00485000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist