Provider Demographics
NPI:1629178934
Name:LEWCZUK, MONIKA (PT)
Entity Type:Individual
Prefix:MRS
First Name:MONIKA
Middle Name:
Last Name:LEWCZUK
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 1:26 VAN TINES LN
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3901
Mailing Address - Country:US
Mailing Address - Phone:732-910-8874
Mailing Address - Fax:
Practice Address - Street 1:100 CRAIG RD STE 206
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8731
Practice Address - Country:US
Practice Address - Phone:732-303-1425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QAO11O5000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHP3254671OtherORTHONET PROVIDER ID
NHP3254671OtherORTHONET PROVIDER ID