Healthcare Provider Details

I. General information

NPI: 1659331098
Provider Name (Legal Business Name): GENEVIEVE MARY BILKIEWICZ CLEVELAND PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15251 NATIONAL AVE
LOS GATOS CA
95032-2400
US

IV. Provider business mailing address

15251 NATIONAL AVE
LOS GATOS CA
95032-2400
US

V. Phone/Fax

Practice location:
  • Phone: 408-356-1990
  • Fax: 408-356-4736
Mailing address:
  • Phone: 408-356-1990
  • Fax: 408-356-4736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11242
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: