Provider Demographics
NPI:1891401022
Name:WASKIEWICZ, WENDY (DPT)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:WASKIEWICZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 WHITNEY AVE STE 450
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-2743
Mailing Address - Country:US
Mailing Address - Phone:413-592-1762
Mailing Address - Fax:
Practice Address - Street 1:330 WHITNEY AVE STE 450
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-2743
Practice Address - Country:US
Practice Address - Phone:413-592-1762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist