Provider Demographics
NPI:1508062142
Name:ANDRZEJEWSKI, STANLEY (PT)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:
Last Name:ANDRZEJEWSKI
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 1:1710 PARSONAGE RD
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21120-9689
Mailing Address - Country:US
Mailing Address - Phone:410-560-2980
Mailing Address - Fax:410-560-3673
Practice Address - Street 1:9628 DEERECO RD
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2120
Practice Address - Country:US
Practice Address - Phone:410-560-2980
Practice Address - Fax:410-560-3673
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD142652251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic