Basic Information
Provider Information
NPI: 1710913579
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARKLEY
FirstName: FRANK
MiddleName: MICHAEL
NamePrefix: DR.
NameSuffix: JR.
Credential: P.T. D.P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2 W 10TH ST
Address2:  
City: MARCUS HOOK
State: PA
PostalCode: 190614513
CountryCode: US
TelephoneNumber: 6108598850
FaxNumber: 6108597876
Practice Location
Address1: 1331 E WYOMING AVE
Address2: SUITE 4120
City: PHILADELPHIA
State: PA
PostalCode: 191243808
CountryCode: US
TelephoneNumber: 2158311170
FaxNumber: 2157447394
Other Information
ProviderEnumerationDate: 06/24/2006
LastUpdateDate: 10/13/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT015658PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

ID Information
IDTypeStateIssuerDescription
3007288101PAKEYSTONE MERCYOTHER
10086008805PA MEDICAID
221732400001PAINDEPENDENCE BLUE CROSSOTHER
171091357905DE MEDICAID
3001679501PAKEYSTONE MERCYOTHER
30618701 UNISONOTHER
00153199001PAHIGHMARK BLUE SHIELDOTHER


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