Provider Demographics
NPI:1962596064
Name:MARCHIARULLO, CHERYL ANN (DPT)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:MARCHIARULLO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-2443
Mailing Address - Country:US
Mailing Address - Phone:973-237-1975
Mailing Address - Fax:973-237-1977
Practice Address - Street 1:590 UNION BLVD
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-2443
Practice Address - Country:US
Practice Address - Phone:973-237-1975
Practice Address - Fax:973-237-1977
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204829225100000X
NJ40QA01327100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2305204829OtherSTATE LICENSE
NJ40QA01327100OtherSTATE LICENSE
NJ40QA01327100OtherSTATE LICENSE
NJ072456Medicare PIN