Provider Demographics
NPI:1578106563
Name:ICHNIOWSKI, JOSEPH (MT-BC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:ICHNIOWSKI
Suffix:
Gender:M
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10408 HUNTLEY AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-3822
Mailing Address - Country:US
Mailing Address - Phone:240-478-5980
Mailing Address - Fax:
Practice Address - Street 1:2801 UPTON ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-3829
Practice Address - Country:US
Practice Address - Phone:202-686-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist