Glynda Leigh Mikolajewski, PT

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT-01508 Issued in OH

Practice address

6215 Troy Pike
Huber Heights, OH 45424-3646

Phone

(937) 236-8111

Fax

(937) 236-4877

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043397128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 LINCOLN ST",
            "city": "PIQUA",
            "state": "OH",
            "postal_code": "453561623",
            "telephone_number": "937-271-4721",
            "fax_number": "937-381-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 TROY PIKE",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454243646",
            "telephone_number": "937-236-8111",
            "fax_number": "937-236-4877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKOLAJEWSKI",
        "first_name": "GLYNDA",
        "middle_name": "LEIGH",
        "name_prefix": "Miss",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "PT-01508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Huber Heights, OH
• Providers in Huber Heights, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.