Provider Demographics
NPI:1750329488
Name:MANKOWSKI AND ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:MANKOWSKI AND ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAL
Authorized Official - Middle Name:W
Authorized Official - Last Name:MANKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:410-744-8698
Mailing Address - Street 1:2909 CHESTNUT HILL DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-3411
Mailing Address - Country:US
Mailing Address - Phone:410-750-9392
Mailing Address - Fax:410-750-8931
Practice Address - Street 1:405 FREDERICK RD
Practice Address - Street 2:SUITE 3
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4645
Practice Address - Country:US
Practice Address - Phone:410-744-8698
Practice Address - Fax:410-744-8699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15445225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1027OtherBRAVO HEALTH
MD18692OtherKAISER PERMANENTE MID-ATLANTIC STATES
MD22309OtherM.D. IPA
MDR776OtherCARE FIRST BLUE CHOICE
MD22309OtherOPTIMUM CHOICE
MD2143999OtherAETNA HMO
MDR7760001OtherCAREFIRST BLUECROSS/BLUE SHIELD FEDERAL EMPLOYEES PROGRAM
MD22309OtherMAMSI
MD22309OtherALLIANCE
MD5800456OtherAETNA PPO
MD8010223PTOtherCIGNA PPO
MD062318101Medicaid
MD146173400OtherO.W.C.P.
MD03186OtherAMERIGROUP
MDJ512OtherCAREFIRST BLUE CROSS/BLUE SHIELD OF MARYLAND
MD22309OtherM.D. IPA
MD062318101Medicaid