Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Marck Mombrun, PTA

Individual provider Physical Therapy Assistant · NPI 1134960750

Marck Mombrun, PTA is a Physical Therapy Assistant in Amityville, New York. Practices as a sole proprietor. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

805 Broadway
Amityville, NY 11701-2260
Phone: (631) 608-8874
Fax: (631) 608-8876
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X

Record details

NPI number1134960750
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorYes
NPI enumeratedJune 6, 2024
Last updated in NPPESJune 6, 2024
Certification dateJune 6, 2024

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