Provider Demographics
NPI:1881645687
Name:URBANOWICZ, MICHAEL (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:URBANOWICZ
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1144
Mailing Address - Country:US
Mailing Address - Phone:973-564-9559
Mailing Address - Fax:973-564-9717
Practice Address - Street 1:52 VANDERBILT AVE
Practice Address - Street 2:SUITE 1413
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-3808
Practice Address - Country:US
Practice Address - Phone:212-599-0099
Practice Address - Fax:212-599-0389
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA02948225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist