Provider Demographics
NPI:1619569449
Name:DOMINIKA PIESTRAK PT PLLC
Entity Type:Organization
Organization Name:DOMINIKA PIESTRAK PT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIKA
Authorized Official - Middle Name:ANNA
Authorized Official - Last Name:PIESTRAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-606-9849
Mailing Address - Street 1:413 S 5TH ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-7488
Mailing Address - Country:US
Mailing Address - Phone:347-606-9849
Mailing Address - Fax:504-384-7421
Practice Address - Street 1:413 S 5TH ST APT 2R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-7488
Practice Address - Country:US
Practice Address - Phone:347-606-9849
Practice Address - Fax:504-384-7421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty