Provider Demographics
NPI:1679828982
Name:PIETRASZEWSKI, MELISSA (PT DPT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:PIETRASZEWSKI
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:CZAJKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT DPT
Mailing Address - Street 1:1700 N MOORE ST STE 1925
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22209-1916
Mailing Address - Country:US
Mailing Address - Phone:703-558-4960
Mailing Address - Fax:
Practice Address - Street 1:1700 N MOORE ST STE 1925
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22209-1916
Practice Address - Country:US
Practice Address - Phone:703-558-4960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035252225100000X
DC871655225100000X
VA2305210974225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1679828982Medicare PIN