Provider Demographics
NPI:1891326591
Name:MARTSCHENKO, PATRICIA M (MSPT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:MARTSCHENKO
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:M
Other - Last Name:GRATZON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:913 POST RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6048
Mailing Address - Country:US
Mailing Address - Phone:203-259-7177
Mailing Address - Fax:203-283-4099
Practice Address - Street 1:913 POST RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6048
Practice Address - Country:US
Practice Address - Phone:203-259-7177
Practice Address - Fax:203-283-4099
Is Sole Proprietor?:No
Enumeration Date:2020-01-31
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8040225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist