Provider Demographics
NPI:1982484499
Name:PIWOWARCZYK, WOJCIECH (PT, DPT, CSCS)
Entity type:Individual
Prefix:
First Name:WOJCIECH
Middle Name:
Last Name:PIWOWARCZYK
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 GRACE AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-2406
Mailing Address - Country:US
Mailing Address - Phone:862-249-2867
Mailing Address - Fax:
Practice Address - Street 1:49 W ALLENDALE AVE
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:NJ
Practice Address - Zip Code:07401-1754
Practice Address - Country:US
Practice Address - Phone:201-825-0623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02196600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist