Provider Demographics
NPI:1255538443
Name:MARQUEZ, ALFIE SHEILA (PT)
Entity type:Individual
Prefix:
First Name:ALFIE
Middle Name:SHEILA
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 NEWARK AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-2302
Mailing Address - Country:US
Mailing Address - Phone:201-420-1165
Mailing Address - Fax:201-420-6893
Practice Address - Street 1:590 NEWARK AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2302
Practice Address - Country:US
Practice Address - Phone:201-420-1165
Practice Address - Fax:201-420-6893
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01212100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist