Provider Demographics
NPI:1740244300
Name:FIALKOWSKI, DANA C (MPT,ATC)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:C
Last Name:FIALKOWSKI
Suffix:
Gender:F
Credentials:MPT,ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 INDIAN TRAIL WAY
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-8937
Mailing Address - Country:US
Mailing Address - Phone:410-870-0170
Mailing Address - Fax:
Practice Address - Street 1:8817 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-2445
Practice Address - Country:US
Practice Address - Phone:410-529-5233
Practice Address - Fax:410-529-3098
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18892225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist