Provider Demographics
NPI:1811521750
Name:BIERNACKI, ELZBIETA
Entity type:Individual
Prefix:
First Name:ELZBIETA
Middle Name:
Last Name:BIERNACKI
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 1:11745 ARBOR GLEN WAY
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20194-1580
Mailing Address - Country:US
Mailing Address - Phone:703-989-8975
Mailing Address - Fax:
Practice Address - Street 1:11745 ARBOR GLEN WAY
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20194-1580
Practice Address - Country:US
Practice Address - Phone:703-989-8975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-01
Last Update Date:2020-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119203222225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist