Provider Demographics
NPI:1538321294
Name:BARTEK, DENNIS (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:BARTEK
Suffix:
Gender:M
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 1:2008 SAINT MICHAELS DR STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7683
Mailing Address - Country:US
Mailing Address - Phone:505-302-0473
Mailing Address - Fax:
Practice Address - Street 1:2008 SAINT MICHAELS DR STE A
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7683
Practice Address - Country:US
Practice Address - Phone:505-302-0473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3532225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMN4536Medicaid
NMN4536Medicaid