Provider Demographics
NPI:1417658667
Name:MAGIERSKI, EMMA A
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:A
Last Name:MAGIERSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 167
Mailing Address - Street 2:
Mailing Address - City:ISLAND HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08732-0167
Mailing Address - Country:US
Mailing Address - Phone:732-232-1882
Mailing Address - Fax:
Practice Address - Street 1:953 FISCHER BLVD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-3835
Practice Address - Country:US
Practice Address - Phone:732-538-8452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00366900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist