Provider Demographics
NPI:1497225619
Name:BLASKIEWICZ, JULIA CATHERINE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:CATHERINE
Last Name:BLASKIEWICZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 KERNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-3144
Mailing Address - Country:US
Mailing Address - Phone:570-877-1514
Mailing Address - Fax:
Practice Address - Street 1:2489 US 6 GRESHAMS LANDING
Practice Address - Street 2:
Practice Address - City:HAWLEY
Practice Address - State:PA
Practice Address - Zip Code:18428
Practice Address - Country:US
Practice Address - Phone:570-390-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025775208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation