Individual
MARTA GOSPODAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
432 E MAIN ST, MIDDLETOWN, DE 19709-1462
(302) 376-4315
(302) 376-4318
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(610) 859-7876
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J10000970
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000050781
DPCI
DE
05
—
1881675320
—
DE
01
—
3744644000
IBC
DE
01
—
P00707428
MEDICARE RR
DE
Enumeration date
11/10/2005
Last updated
07/16/2024
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