Provider Demographics
NPI:1952506487
Name:WYNEKUS, JOANNA MICHELLE APOLINAR (PT)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA MICHELLE
Middle Name:APOLINAR
Last Name:WYNEKUS
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 1:1565 WASHINGTON CT
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-2811
Mailing Address - Country:US
Mailing Address - Phone:609-703-6608
Mailing Address - Fax:
Practice Address - Street 1:4000 ROUTE 9 S
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:NJ
Practice Address - Zip Code:08242-1912
Practice Address - Country:US
Practice Address - Phone:609-889-8447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01121600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist