Doctor Name: | MICHAEL JAMES WYLYKANOWITZ |
NPI Number: | 1457647307 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | 40QA01398100 |
Business Practice Address: | 34 Mountain Blvd Building C Warren, NJ - 070592640 |
Business Phone Number: | 9082220515 |
Business Fax Number: | 9082220516 |
Mailing Address: | 622 Eagle Rock Ave, WEST ORANGE |
State: | NJ |
Postal Code: | 070522994 |
Phone Number: | 9736690078 |
Fax Number: | 9736691113 |
NPI Enumeration Date: | 06/20/2011 |
NPI Last Update Date: | 01/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 40QA01398100 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |