Provider Demographics
NPI:1992882039
Name:MROWKA PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:MROWKA PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MROWKA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:203-250-0334
Mailing Address - Street 1:423 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410
Mailing Address - Country:US
Mailing Address - Phone:203-250-0334
Mailing Address - Fax:203-250-0336
Practice Address - Street 1:423 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410
Practice Address - Country:US
Practice Address - Phone:203-250-0334
Practice Address - Fax:203-250-0336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003788225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0106401OtherACS ORTHONET
OV1701OtherHEALTHNET
ANC1107OtherOXFORD HEALTH PLAN
080003788CT07OtherANTHEM BLUE CROSS AND BLU
650007915OtherMEDICARE RAILROAD
83826OtherAETNA
=========OtherUNITED HEALTHCARE
OV1701OtherHEALTHNET
080003788CT07OtherANTHEM BLUE CROSS AND BLU