Provider Demographics
NPI:1427177781
Name:MORAWSKI, MARIUSZ CEZARY (PT)
Entity type:Individual
Prefix:
First Name:MARIUSZ
Middle Name:CEZARY
Last Name:MORAWSKI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 GOODRICH AVE
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-3212
Mailing Address - Country:US
Mailing Address - Phone:716-372-4570
Mailing Address - Fax:
Practice Address - Street 1:515 MAIN ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1513
Practice Address - Country:US
Practice Address - Phone:716-375-7481
Practice Address - Fax:716-375-6410
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016494-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist