Provider Demographics
NPI:1063546042
Name:WALASZEK, PATRICIA HOFFERT (PT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:HOFFERT
Last Name:WALASZEK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 W PINE RD
Mailing Address - Street 2:
Mailing Address - City:STAATSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12580-5405
Mailing Address - Country:US
Mailing Address - Phone:845-889-4519
Mailing Address - Fax:
Practice Address - Street 1:67 W PINE RD
Practice Address - Street 2:
Practice Address - City:STAATSBURG
Practice Address - State:NY
Practice Address - Zip Code:12580-5405
Practice Address - Country:US
Practice Address - Phone:845-889-4519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004257225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist