Provider Demographics
NPI:1497875165
Name:LOPSONZSKI, VANESSA (PT)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:LOPSONZSKI
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 1:10400 FERNWOOD RD
Mailing Address - Street 2:LL131
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1102
Mailing Address - Country:US
Mailing Address - Phone:202-257-6028
Mailing Address - Fax:
Practice Address - Street 1:10400 FERNWOOD RD
Practice Address - Street 2:LL131
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1102
Practice Address - Country:US
Practice Address - Phone:202-257-6028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDT-5932225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT-5932OtherPT LICENCE