Provider Demographics
NPI:1346294618
Name:SZYMCZAK, LINDA M (PT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:SZYMCZAK
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 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:508-856-9510
Mailing Address - Fax:508-853-1907
Practice Address - Street 1:135 GOLD STAR BLVD
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606
Practice Address - Country:US
Practice Address - Phone:508-856-9510
Practice Address - Fax:508-853-1907
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2936225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0366234OtherMEDICAID WELFARE
Y67938OtherBLUE SHIELD HMO BLUE
042472266OtherTHREE RIVERS
2779432OtherCIGNA HEALTH PLAN
44340OtherFALLON COMMUNITY HEALTH P
Y67938OtherBLUE CARE ELECT
042472266OtherONE HEALTH PLAN
787404OtherMVP HEALTH CARE
AA4052OtherHARVARD PILGRIM HEALTHCAR
Y68680OtherMEDICARE B
042472266OtherHEALTHCARE VALUE MANAGEME
042472266OtherPRIVATE HEALTHCARE SYSTEM
MA0366234Medicaid
7268602OtherAETNA US HEALTHCARE
Y67938OtherBLUE SHIELD INDEMNITY
MA0366234Medicaid