Individual
DONNA M BANIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
770 NEWTOWN YARDLEY RD, SUITE 210, NEWTOWN, PA 18940-1748
(215) 860-7031
(215) 860-5704
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-007340-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001345806
BLUE SHIELD NUMBER
PA
Enumeration date
01/26/2007
Last updated
12/28/2015
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