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NPI Code Detail

MEDICARE: MR. PAWEL MADRY PHYSICAL THERAPIST

MEDICARE: MR. PAWEL MADRY PHYSICAL THERAPIST
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
1225100000XPhysical Therapist021524-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710082128
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PAWEL MADRY PHYSICAL THERAPIST
Provider Business Mailing Address
First Line : 934 MANHATTAN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11222-5928
Country : US
Telephone Number : 718-389-8585
Fax Number :
Provider Business Practice Location Address
First Line : 934 MANHATTAN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11222-5928
Country : US
Telephone Number : 718-389-8585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 07/21/2022

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