Provider Demographics
NPI:1154656643
Name:MIERZEJEWSKI, PAULINA (MSPT)
Entity Type:Individual
Prefix:MISS
First Name:PAULINA
Middle Name:
Last Name:MIERZEJEWSKI
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 LOWELL RD
Mailing Address - Street 2:APT 203
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864-1679
Mailing Address - Country:US
Mailing Address - Phone:716-883-0031
Mailing Address - Fax:
Practice Address - Street 1:106 LOWELL RD
Practice Address - Street 2:APT 203
Practice Address - City:NORTH READING
Practice Address - State:MA
Practice Address - Zip Code:01864-1679
Practice Address - Country:US
Practice Address - Phone:716-883-0031
Practice Address - Fax:855-232-8604
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025578225100000X
MA21766225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist