Provider Demographics
NPI:1629229380
Name:PASLAWSKI, NEIL ADAM (PT, DPT, ATC)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:ADAM
Last Name:PASLAWSKI
Suffix:
Gender:M
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1844 E BASELINE RD
Mailing Address - Street 2:STE. C-5
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1510
Mailing Address - Country:US
Mailing Address - Phone:480-833-1005
Mailing Address - Fax:480-833-1312
Practice Address - Street 1:1844 E BASELINE RD
Practice Address - Street 2:STE. C-5
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1510
Practice Address - Country:US
Practice Address - Phone:480-833-1005
Practice Address - Fax:480-833-1312
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ378526Medicaid
AZ125802Medicare PIN
AZZ79354Medicare PIN
AZZ102616Medicare PIN
AZ378526Medicaid