Provider Demographics
NPI:1487696902
Name:SWIATEK, MAUREEN (MSPT, CHT)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:SWIATEK
Suffix:
Gender:F
Credentials:MSPT, CHT
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:
Other - Last Name:FOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1602 NEWPORT GAP PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-6208
Mailing Address - Country:US
Mailing Address - Phone:302-633-5840
Mailing Address - Fax:302-633-5844
Practice Address - Street 1:750 PRIDES XING STE 112
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-6107
Practice Address - Country:US
Practice Address - Phone:302-864-2222
Practice Address - Fax:302-907-4028
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251H1200X
DEJ10001211225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000037753Medicaid
PA1689521OtherPA BS PROVIDER ID
5070-0008OtherCARE FIRST
279995OtherMAMSI PROVIDER ID
61810001OtherNCA
$$$$$$$$$OtherCHAMPUS
DE1000037753Medicaid
$$$$$$$$$OtherCHAMPUS
61810001OtherNCA