MEDICARE: MAKAYLA KWIEJ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	TPTA000900	PA

General Provider Information

NPI Number	:	1043143381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAKAYLA KWIEJ

Provider Business Mailing Address
First Line	:	15 LONGACRE DR
Second Line	:
City	:	COLLEGEVILLE
State	:	PA
Zip	:	19426-2897
Country	:	US
Telephone Number	:	484-213-4614
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 EVERGREEN RD
Second Line	:
City	:	POTTSTOWN
State	:	PA
Zip	:	19464-3143
Country	:	US
Telephone Number	:	610-323-1800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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