Provider Demographics
NPI:1790999217
Name:DECOWSKA, JOANNA EWELINA (PT)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:EWELINA
Last Name:DECOWSKA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 ELIZABETH AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07201-2710
Mailing Address - Country:US
Mailing Address - Phone:908-629-0779
Mailing Address - Fax:908-629-0804
Practice Address - Street 1:909 ELIZABETH AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07201-2710
Practice Address - Country:US
Practice Address - Phone:908-629-0779
Practice Address - Fax:908-629-0804
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy