Provider Demographics
NPI:1790916773
Name:BELENKY, ANNA KARASIK (PT)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:KARASIK
Last Name:BELENKY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:KARASIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3400 W 66TH ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2111
Mailing Address - Country:US
Mailing Address - Phone:952-920-8088
Mailing Address - Fax:952-920-5162
Practice Address - Street 1:3400 W 66TH ST
Practice Address - Street 2:SUITE 150
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2111
Practice Address - Country:US
Practice Address - Phone:952-920-8088
Practice Address - Fax:952-920-5162
Is Sole Proprietor?:No
Enumeration Date:2009-08-07
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8369225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist