Provider Demographics
NPI:1699986737
Name:DUBIELA, MARIUSZ (PT)
Entity type:Individual
Prefix:
First Name:MARIUSZ
Middle Name:
Last Name:DUBIELA
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 1:46 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-5813
Mailing Address - Country:US
Mailing Address - Phone:603-742-4779
Mailing Address - Fax:
Practice Address - Street 1:1 WALDRON CT
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3354
Practice Address - Country:US
Practice Address - Phone:603-866-0380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1972225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist