MEDICARE: DR. JOANNA DECOWSKA DPT LLC

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	40QA01050700	NJ

General Provider Information

NPI Number	:	1932581113
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. JOANNA DECOWSKA DPT LLC

Provider Business Mailing Address
First Line	:	38 PEAR TREE LN
Second Line	:
City	:	FRANKLIN PARK
State	:	NJ
Zip	:	08823-1404
Country	:	US
Telephone Number	:	732-288-4136
Fax Number	:

Provider Business Practice Location Address
First Line	:	38 PEAR TREE LN
Second Line	:
City	:	FRANKLIN PARK
State	:	NJ
Zip	:	08823-1404
Country	:	US
Telephone Number	:	732-288-4136
Fax Number	:

Authorized Official
Title or Position	:	PROPRIETOR
Name	:	DR. JOANNA DECOWSKA
Credential	:	DPT
Telephone Number	:	732-288-4136

Provider Enumeration Date	:	06/23/2015
Last Update Date	:	06/23/2015

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