MEDICARE: MICHAEL J SOWINSKI PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	40QA01707600	NJ

General Provider Information

NPI Number	:	1083157655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL J SOWINSKI PT, DPT

Provider Business Mailing Address
First Line	:	PO BOX 1014
Second Line	:
City	:	CLARK
State	:	NJ
Zip	:	07066-1014
Country	:	US
Telephone Number	:	732-855-9751
Fax Number	:	732-855-9755

Provider Business Practice Location Address
First Line	:	1081 ROUTE 22 STE 204
Second Line	:
City	:	BRIDGEWATER
State	:	NJ
Zip	:	08807-2921
Country	:	US
Telephone Number	:	732-427-8171
Fax Number	:	732-855-9755

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2016
Last Update Date	:	03/02/2020

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