Provider Demographics
NPI:1538276043
Name:DUBIEL, MARIE
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:DUBIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 PHEASANT RUN
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2943
Mailing Address - Country:US
Mailing Address - Phone:732-452-1476
Mailing Address - Fax:
Practice Address - Street 1:904 OAK TREE AVE STE S
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5126
Practice Address - Country:US
Practice Address - Phone:908-756-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ40QA00551400OtherLICENSE #