Provider Demographics
NPI:1780818757
Name:JUSKOWICZ, ISRAEL CHAIM (DPT)
Entity Type:Individual
Prefix:
First Name:ISRAEL
Middle Name:CHAIM
Last Name:JUSKOWICZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10784 BREWER HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3452
Mailing Address - Country:US
Mailing Address - Phone:917-742-3209
Mailing Address - Fax:
Practice Address - Street 1:6615 REISTERSTOWN RD STE 300
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-2689
Practice Address - Country:US
Practice Address - Phone:443-627-8921
Practice Address - Fax:410-258-9975
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24463225100000X
NY027803-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics