Provider Demographics
NPI:1720673981
Name:MIERZEJEWSKA, MARGARET EUGENIA
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:EUGENIA
Last Name:MIERZEJEWSKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 W HAWTHORNE AVE
Mailing Address - Street 2:STE 210
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-6126
Mailing Address - Country:US
Mailing Address - Phone:718-793-3200
Mailing Address - Fax:
Practice Address - Street 1:116 39TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-2712
Practice Address - Country:US
Practice Address - Phone:718-793-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty