Individual
MRS. TERESA ICHNIOWSKI
Active
Individual
MRS. TERESA ICHNIOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
14713
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
612022-01
BC BS
MD
Enumeration date
02/06/2007
Last updated
09/23/2009
Update your record
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