Rosemarie Jaworski, PT
Individual provider Active NPI Physical Therapist · Elycia, OH
NPI 1124084801 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124084801
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT02534 (OH)
- Practice address
- 137 Winckles Street
Elycia, OH 44035 - Phone
- (440) 366-5993
- Fax
- (440) 366-5313
- NPI assigned
- Apr 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT02534 | OH | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT02534 | OH | Yes |
Addresses
Primary practice location
137 Winckles Street
Elycia, OH 44035
Mailing address
137 Winckles Street
Elycia, OH 44035
Phone (440) 366-5993
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000132803 | Other | OH | ANTHEM BCBS |
| 341490517033 | Other | OH | CARE SOURCE |
| 2167462 | Medicaid | OH | |
| 654140 | Other | OH | AETNA |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.