Provider Demographics
NPI:1477894624
Name:MARQUEZ, ROBIN RYAN (MSPT, CWS, CLT, CIDN)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:RYAN
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:MSPT, CWS, CLT, CIDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 LINDEN ST STE 103
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-7915
Mailing Address - Country:US
Mailing Address - Phone:798-263-0060
Mailing Address - Fax:781-459-0051
Practice Address - Street 1:148 LINDEN ST STE 103
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-7915
Practice Address - Country:US
Practice Address - Phone:798-263-0060
Practice Address - Fax:781-459-0051
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12138225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA225760Medicare UPIN