Provider Demographics
NPI:1710034947
Name:SZEKELY, VANDA MAGDOLNA (MPT)
Entity Type:Individual
Prefix:
First Name:VANDA
Middle Name:MAGDOLNA
Last Name:SZEKELY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2747 KATHRYN AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-3103
Mailing Address - Country:US
Mailing Address - Phone:505-203-6376
Mailing Address - Fax:
Practice Address - Street 1:9201 MONTGOMERY BLVD NE
Practice Address - Street 2:SUITE 302
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2468
Practice Address - Country:US
Practice Address - Phone:505-293-6262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3298225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM3298OtherLICENSE NUMBER