Healthcare Provider Details

I. General information

NPI: 1215962683
Provider Name (Legal Business Name): BRITTANY CATHERINE CZERW MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRITTANY CATHERINE BENNETT

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 04/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8131 ROOSEVELT BLVD
PHILADELPHIA PA
19152-3013
US

IV. Provider business mailing address

7901 HENRY AVE APT C305
PHILADELPHIA PA
19128-3060
US

V. Phone/Fax

Practice location:
  • Phone: 215-335-3954
  • Fax:
Mailing address:
  • Phone: 215-482-3723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT016414
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: