Provider Demographics
NPI:1265696132
Name:BETLEJEWSKI, ELIZABETH JAYNE (MSPT, CWCE)
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:JAYNE
Last Name:BETLEJEWSKI
Suffix:
Gender:F
Credentials:MSPT, CWCE
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:JAYNE
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12 NEWPORT DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-1758
Mailing Address - Country:US
Mailing Address - Phone:410-838-6808
Mailing Address - Fax:410-838-2511
Practice Address - Street 1:12 NEWPORT DR
Practice Address - Street 2:SUITE A
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-1758
Practice Address - Country:US
Practice Address - Phone:410-838-6808
Practice Address - Fax:410-838-2511
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01891225100000X
MD24143225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist