Individual
ELENA V BYZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1745 CAMELOT DR STE 100, VIRGINIA BEACH, VA 23454-2435
(757) 961-4800
(757) 961-0233
Mailing address
350 NEW FIDELITY CT, GARNER, NC 27529-2665
(919) 373-2919
(410) 648-4878
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305208828
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942609185
MEDICAID QMB
VA
01
—
C05954
GROUP MEDICARE PTAN
VA
Enumeration date
08/13/2014
Last updated
08/10/2022
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