Provider Demographics
NPI:1811184948
Name:WEBER, MARIE OLDAKOWSKI (PT)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:OLDAKOWSKI
Last Name:WEBER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 JENNIFER LN
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3660
Mailing Address - Country:US
Mailing Address - Phone:610-275-4801
Mailing Address - Fax:610-275-9828
Practice Address - Street 1:1403 SHIRLEY LN
Practice Address - Street 2:
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-2868
Practice Address - Country:US
Practice Address - Phone:215-453-0615
Practice Address - Fax:215-453-2076
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006701L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT006701LOtherPA PT LICENSE NUMBER