Provider Demographics
NPI:1992994602
Name:JANZEF, GERALYN (PT)
Entity type:Individual
Prefix:
First Name:GERALYN
Middle Name:
Last Name:JANZEF
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 1:524 CLEAR MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27107-6477
Mailing Address - Country:US
Mailing Address - Phone:336-971-5995
Mailing Address - Fax:
Practice Address - Street 1:279 BRIAN CENTER DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-6273
Practice Address - Country:US
Practice Address - Phone:336-236-8114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6131225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist