Provider Demographics
NPI:1487809851
Name:MADEJ, ANNA MARIA (PT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIA
Last Name:MADEJ
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 1:128 SKYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-4673
Mailing Address - Country:US
Mailing Address - Phone:607-433-7378
Mailing Address - Fax:607-433-7378
Practice Address - Street 1:128 SKYVIEW DR
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-4673
Practice Address - Country:US
Practice Address - Phone:607-433-7378
Practice Address - Fax:607-433-7378
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018245-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist