Provider Demographics
NPI:1346271723
Name:MYSLIWIEC, ANNA MARIA (DPT)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MARIA
Last Name:MYSLIWIEC
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:MARIA
Other - Last Name:POBLETE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2W NORTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-3789
Mailing Address - Country:US
Mailing Address - Phone:973-369-7161
Mailing Address - Fax:973-369-7163
Practice Address - Street 1:2 W NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-3789
Practice Address - Country:US
Practice Address - Phone:973-369-7161
Practice Address - Fax:973-369-7163
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01110200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist