Provider Demographics
NPI:1669438255
Name:ZAULYCZNY, WALTER A (MS PT)
Entity type:Individual
Prefix:MR
First Name:WALTER
Middle Name:A
Last Name:ZAULYCZNY
Suffix:
Gender:M
Credentials:MS PT
Other - Prefix:
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Mailing Address - Street 1:7 CARNEGIE PLZ
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1000
Mailing Address - Country:US
Mailing Address - Phone:877-407-3422
Mailing Address - Fax:877-407-4329
Practice Address - Street 1:7 CARNEGIE PLZ
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1000
Practice Address - Country:US
Practice Address - Phone:877-407-3422
Practice Address - Fax:877-407-4329
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-24
Last Update Date:2013-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA40QA00287800225100000X, 2251S0007X
MA40QA00287002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ520345QK7Medicare ID - Type Unspecified