Provider Demographics
NPI:1588693774
Name:PIETRUSZKIEWICZ, ALAN J (MSPT)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:J
Last Name:PIETRUSZKIEWICZ
Suffix:
Gender:M
Credentials:MSPT
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Mailing Address - Street 1:8201 ATLEE ROAD
Mailing Address - Street 2:SUITE D
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116
Mailing Address - Country:US
Mailing Address - Phone:804-569-1787
Mailing Address - Fax:804-569-9787
Practice Address - Street 1:8201 ATLEE ROAD
Practice Address - Street 2:SUITE D
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116
Practice Address - Country:US
Practice Address - Phone:804-569-1787
Practice Address - Fax:804-569-9787
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2007-08-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA2305005749225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA192348OtherANTHEM BS
VAP00298797OtherRR MEDICARE
VA192348OtherANTHEM BS
VA00X000P01Medicare PIN