Provider Demographics
NPI:1699834580
Name:PIKARSKY, GISELA (PT)
Entity Type:Individual
Prefix:MRS
First Name:GISELA
Middle Name:
Last Name:PIKARSKY
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 1:47 MYSTIC ST
Mailing Address - Street 2:#8-B
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-1126
Mailing Address - Country:US
Mailing Address - Phone:781-641-1205
Mailing Address - Fax:
Practice Address - Street 1:47 MYSTIC ST
Practice Address - Street 2:#8-B
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-1135
Practice Address - Country:US
Practice Address - Phone:781-641-1205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1786225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY65175Medicare ID - Type UnspecifiedPHYSICAL THERAPY