Healthcare Provider Details

I. General information

NPI: 1699064956
Provider Name (Legal Business Name): MEGHAN OKONIEWSKI HAUS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGHAN OKONIEWSKI

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 05/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23123 CAMDEN WAY
CALIFORNIA MD
20619-2446
US

IV. Provider business mailing address

11855 HG TRUEMAN RD
LUSBY MD
20657-2855
US

V. Phone/Fax

Practice location:
  • Phone: 301-862-5177
  • Fax: 301-862-4959
Mailing address:
  • Phone: 410-326-3432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number23594
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: