MEDICARE: JANE KRUSZEWSKI PT, DPT, OCS, ATC

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	2251S0007X	Sports Physical Therapist	27858	MD
2	2251S0007X	Sports Physical Therapist	2305212030	VA
3	2251X0800X	Orthopedic Physical Therapist	1233585	TX
4	2251S0007X	Sports Physical Therapist	871513	DC

General Provider Information

NPI Number	:	1912330242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE KRUSZEWSKI PT, DPT, OCS, ATC

Provider Business Mailing Address
First Line	:	108 S FENWICK ST
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22204-1835
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1228 BLAGDEN ALY NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20001-4434
Country	:	US
Telephone Number	:	202-705-9330
Fax Number	:

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

Provider Enumeration Date	:	08/09/2013
Last Update Date	:	07/08/2024

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