MEDICARE: PATRICIA MACIBORSKI PT

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	225100000X	Physical Therapist	2435	MA
2	2251P0200X	Pediatric Physical Therapist	40QA00308100	NJ

General Provider Information

NPI Number	:	1205803715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA MACIBORSKI PT

Provider Business Mailing Address
First Line	:	71 GRIST MILL DR
Second Line	:
City	:	BELLE MEAD
State	:	NJ
Zip	:	08502-5505
Country	:	US
Telephone Number	:	908-874-4883
Fax Number	:

Provider Business Practice Location Address
First Line	:	71 GRIST MILL DR
Second Line	:
City	:	BELLE MEAD
State	:	NJ
Zip	:	08502-5505
Country	:	US
Telephone Number	:	908-874-4883
Fax Number	:

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

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	09/11/2025

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