Provider Demographics
NPI:1851448021
Name:MAROSZEK, MONIKA (PT)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:MAROSZEK
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 1:35620 SAXONY DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-5187
Mailing Address - Country:US
Mailing Address - Phone:586-268-8319
Mailing Address - Fax:586-727-0028
Practice Address - Street 1:31505 32 MILE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MI
Practice Address - Zip Code:48062-5215
Practice Address - Country:US
Practice Address - Phone:586-727-0018
Practice Address - Fax:586-727-0028
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004633225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION58040OtherHAP HMO