Provider Demographics
NPI:1700925518
Name:Z.LASZCZYK, PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:Z.LASZCZYK, PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZBIGNIEW
Authorized Official - Middle Name:
Authorized Official - Last Name:LASZCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:347-282-8058
Mailing Address - Street 1:7115 3RD AVE
Mailing Address - Street 2:APT 2D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1347
Mailing Address - Country:US
Mailing Address - Phone:347-282-8058
Mailing Address - Fax:347-350-6248
Practice Address - Street 1:115 NASSAU AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-3217
Practice Address - Country:US
Practice Address - Phone:718-389-2121
Practice Address - Fax:347-350-6248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014652225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ3W7C1Medicare PIN