Individual
BERNADETTE MARCELO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
590 ANDERSON AVE, CLIFFSIDE PARK, NJ 07010-1721
(201) 941-8667
Mailing address
95 PALISADE AVE, LEONIA, NJ 07605-1935
(201) 461-4139
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTA40QB00250900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA40QB00250900
PTA LICENSE NUMBER
NJ
Enumeration date
06/12/2007
Last updated
07/08/2007
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