Provider Demographics
NPI:1649500224
Name:KIELSZNIA, HENRYK STEFAN (PT)
Entity type:Individual
Prefix:MR
First Name:HENRYK
Middle Name:STEFAN
Last Name:KIELSZNIA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 REALITY DR
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-3117
Mailing Address - Country:US
Mailing Address - Phone:973-830-9053
Mailing Address - Fax:
Practice Address - Street 1:816 8TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4192
Practice Address - Country:US
Practice Address - Phone:718-788-5762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-05
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027775225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist