Provider Demographics
NPI:1073731964
Name:BARANSKA, EWA (PT)
Entity Type:Individual
Prefix:
First Name:EWA
Middle Name:
Last Name:BARANSKA
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:PO BOX 40696
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-0696
Mailing Address - Country:US
Mailing Address - Phone:317-626-5859
Mailing Address - Fax:
Practice Address - Street 1:1060 E 86TH ST
Practice Address - Street 2:SUITE 65C
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1863
Practice Address - Country:US
Practice Address - Phone:317-626-5859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05004392A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist