Healthcare Provider Details

I. General information

NPI: 1912330242
Provider Name (Legal Business Name): JANE KRUSZEWSKI PT, DPT, OCS, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2013
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1228 BLAGDEN ALY NW
WASHINGTON DC
20001-4434
US

IV. Provider business mailing address

108 S FENWICK ST
ARLINGTON VA
22204-1835
US

V. Phone/Fax

Practice location:
  • Phone: 202-705-9330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number27858
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number2305212030
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number1233585
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number871513
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: