Healthcare Provider Details

I. General information

NPI: 1972793172
Provider Name (Legal Business Name): NOJCIECH MICHAEL SZAFRANSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 CHERRY STREET THERAPIST ON DEMAND,INC.
PHILADELPHIA PA
19106
US

IV. Provider business mailing address

1832 CHIANTI PL
EASTON PA
18045-5446
US

V. Phone/Fax

Practice location:
  • Phone: 800-974-6383
  • Fax:
Mailing address:
  • Phone: 610-691-8427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTE007362
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: