Provider Demographics
NPI:1841400249
Name:KACZMARSKI, MALGORZATA M (OTR)
Entity Type:Individual
Prefix:MRS
First Name:MALGORZATA
Middle Name:M
Last Name:KACZMARSKI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6103 COVENTRY WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-6824
Mailing Address - Country:US
Mailing Address - Phone:856-273-5971
Mailing Address - Fax:
Practice Address - Street 1:1399 CHAPEL AVE W
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2233
Practice Address - Country:US
Practice Address - Phone:856-663-1490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TROO441000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist