Provider Demographics
NPI:1164676250
Name:CHLOPECKI, CAROLYN BETH (MSPT)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:BETH
Last Name:CHLOPECKI
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 1:6 QUEENS GATE DR
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:NY
Mailing Address - Zip Code:12834-2842
Mailing Address - Country:US
Mailing Address - Phone:518-692-1186
Mailing Address - Fax:
Practice Address - Street 1:6 QUEENS GATE DR
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:NY
Practice Address - Zip Code:12834-2842
Practice Address - Country:US
Practice Address - Phone:518-692-1186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-16
Last Update Date:2019-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18554225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist