Provider Demographics
NPI:1144681297
Name:MARQUES, WILLIAM (PT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:MARQUES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 FOREST DR
Mailing Address - Street 2:
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1937
Mailing Address - Country:US
Mailing Address - Phone:978-836-0332
Mailing Address - Fax:631-580-5222
Practice Address - Street 1:39 E HANOVER AVE STE C1
Practice Address - Street 2:
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-2456
Practice Address - Country:US
Practice Address - Phone:973-500-8582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-17
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01890100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty