Individual
MR. MARC CORRES ESTACIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
185 N RTE 17 STE 101B, PARAMUS, NJ 07652-2963
(201) 584-4509
Mailing address
30 HAMILTON AVE, DUMONT, NJ 07628-2003
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00410400
NJ
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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