Provider Demographics
NPI:1912140062
Name:ZAWADZKA, MONIKA KATARZYNA (PTA)
Entity type:Individual
Prefix:MRS
First Name:MONIKA
Middle Name:KATARZYNA
Last Name:ZAWADZKA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:768 BUNKER HILL AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-4443
Mailing Address - Country:US
Mailing Address - Phone:609-695-0384
Mailing Address - Fax:609-695-0384
Practice Address - Street 1:112 FRANKLIN CORNER RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2104
Practice Address - Country:US
Practice Address - Phone:609-896-1494
Practice Address - Fax:609-896-3627
Is Sole Proprietor?:No
Enumeration Date:2009-04-18
Last Update Date:2009-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00264500225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant