Provider Demographics
NPI:1407805385
Name:NOSARZEWSKI, TOMASZ J (PT)
Entity Type:Individual
Prefix:
First Name:TOMASZ
Middle Name:J
Last Name:NOSARZEWSKI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 HEDGEWOOD PT
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38558-4514
Mailing Address - Country:US
Mailing Address - Phone:931-456-5757
Mailing Address - Fax:931-456-5757
Practice Address - Street 1:29 TAYLOR AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-4526
Practice Address - Country:US
Practice Address - Phone:931-456-5757
Practice Address - Fax:931-456-5533
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000003608225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5726340001OtherMEDICARE DME
TN650021404OtherRAILROAD MEDICARE
TN5726340001OtherMEDICARE DME