Provider Demographics
NPI:1700971454
Name:APPEL, TETIANA D (PT)
Entity Type:Individual
Prefix:
First Name:TETIANA
Middle Name:D
Last Name:APPEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TETIANA
Other - Middle Name:D
Other - Last Name:RADOMSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:474 N LAKE SHORE DR
Mailing Address - Street 2:UNIT 5803
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2140 BABCOCK RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4424
Practice Address - Country:US
Practice Address - Phone:210-593-0578
Practice Address - Fax:210-614-3261
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1155298225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
8F1672Medicare ID - Type Unspecified