Provider Demographics
NPI:1336264142
Name:BARUFKIN, HEIDI S (PTA)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:S
Last Name:BARUFKIN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5510 S EDINBOURGH DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53146-4706
Mailing Address - Country:US
Mailing Address - Phone:773-315-3744
Mailing Address - Fax:
Practice Address - Street 1:2730 W RAMSEY AVE
Practice Address - Street 2:PRO STEP
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53221-4814
Practice Address - Country:US
Practice Address - Phone:414-282-2051
Practice Address - Fax:414-282-2051
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2130-19225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant