Provider Demographics
NPI:1679533103
Name:SZALWINSKI, DEBRA (PT, CERT MDT)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
Last Name:SZALWINSKI
Suffix:
Gender:F
Credentials:PT, CERT MDT
Other - Prefix:MS
Other - First Name:DEBRA
Other - Middle Name:D
Other - Last Name:WILLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:771 PILOT HOUSE DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606
Mailing Address - Country:US
Mailing Address - Phone:757-873-2302
Mailing Address - Fax:757-873-2306
Practice Address - Street 1:204 GUMWOOD DR
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:VA
Practice Address - Zip Code:23430-6087
Practice Address - Country:US
Practice Address - Phone:757-357-7762
Practice Address - Fax:757-357-7765
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2011-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305002468225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA298498OtherBCBS PHYSICAL THERAPY
VA650004998OtherRAILROAD MEDICARE
VA8928681Medicaid
VA5698086OtherAETNA
VAC08381Medicare PIN
VA5698086OtherAETNA
VAC05954Medicare PIN
VA650000214Medicare PIN