Provider Demographics
NPI:1073115101
Name:BANIEWICZ PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:BANIEWICZ PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:BANIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:215-968-1000
Mailing Address - Street 1:94 GREENBRIAR LN
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1680
Mailing Address - Country:US
Mailing Address - Phone:215-968-1000
Mailing Address - Fax:
Practice Address - Street 1:11 FRIENDS LN STE 103
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1885
Practice Address - Country:US
Practice Address - Phone:215-968-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty