Provider Demographics
NPI:1851694780
Name:BOGUSLAWSKA, ANNA HELENA (PT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:HELENA
Last Name:BOGUSLAWSKA
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:PO BOX 455
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00821-0455
Mailing Address - Country:US
Mailing Address - Phone:340-277-7391
Mailing Address - Fax:
Practice Address - Street 1:3022 EST GOLDEN ROCK
Practice Address - Street 2:SUITE 101
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-3804
Practice Address - Country:US
Practice Address - Phone:340-718-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI125225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist