Provider Demographics
NPI:1932161478
Name:LINKIEWICZ, MICHAEL L II (PT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:LINKIEWICZ
Suffix:II
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-2810
Mailing Address - Country:US
Mailing Address - Phone:315-434-9353
Mailing Address - Fax:315-434-5581
Practice Address - Street 1:222 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-2810
Practice Address - Country:US
Practice Address - Phone:315-434-9353
Practice Address - Fax:315-434-5581
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011796225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB3764Medicare ID - Type UnspecifiedMEDICARE NUMBER