LORI DOMINICZAK (NPI# 1548450372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548450372 |
| Entity Type | Individual |
| Full Name | LORI DOMINICZAK |
| Credential | PT |
| Practice Address |
4002 W Cherrywood Ln Brown Deer WI 53209-1002 |
| Practice Telephone | 4143783375 |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2007-07-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
2714-024 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 40440700 | 05 |
| Street Address |
4002 W CHERRYWOOD LN |
| City | BROWN DEER |
| State | WI |
| Zip Code | 53209-1002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730327073 | Dominiczak Therapy Associates, LLC | Physical Therapist | 4002 W Cherrywood Ln, Brown Deer, WI 53209-1002 | 2009-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780238253 | Niajcia Brookshire | Counselor | 3900 W Brown Deer Rd Suite 200, Brown Deer, WI 53209 | 2019-08-01 |
| 1740751015 | Mary Fuller | Home Health Aide | 3043 N 29th St., Milwaukee, WI 53209 | 2018-12-16 |
| 1154869410 | Jacksonscott2 | Skilled Nursing Facility | 4573 N. 22nd Street, Milwaukee, WI 53209 | 2017-02-07 |
| 1669910469 | Dimera House | In Home Supportive Care | 4002 W Fairount Ave, Milwaukee, WI 53209 | 2017-02-01 |
| 1891248340 | Amy L May | Nurse Practitioner | 3303 W Good Hope Rd, Milwaukee, WI 53209 | 2016-08-02 |
| 1871980193 | Alan R Rosenthal | Pharmacist | 6930 N Beech Tree Dr, Milwaukee, WI 53209 | 2015-04-24 |
| 1104212380 | Reema Shah | Student in an Organized Health Care Education/Training Program | 2400 W. Villard Ave, Milwaukee, WI 53209 | 2015-04-14 |
| 1336534403 | Robert Michael Kitsis | Family Medicine | 9252 N Green Bay Rd Fl 2, Brown Deer, WI 53209 | 2015-04-05 |
| 1962891994 | Kls Community Outreach Teen Center Consulting and Management L.L.C. | Public Health or Welfare | 8330 North Teutonia Ave Suite 103, Brown Deer, WI 53209 | 2015-01-14 |
| 1548659634 | Kls Community Outreach Teen Center Consulting and Management L.L.C. | Early Intervention Provider Agency | 8330 North Teutonia Avenue Suite 103, Brown Deer, WI 53209 | 2015-01-13 |
| Find all providers in zip 53209 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013321124 | Victoria Ann Moerchen | Physical Therapist | 3409 N Downer Avenue, Uwm, Pavilion, Pt Suite, Rm 366, Milwaukee, WI 53211-2956 | 2014-06-17 |
| 1922368323 | Courtney Wilder | Physical Therapist | 1100 Commerce Drive Suite 114, Racine, WI 53406 | 2012-05-21 |
| 1467763508 | Douglas Litscher | Physical Therapist | 125 Monroe Ave, Rice Lake, WI 54868-3204 | 2010-06-23 |
| 1306163761 | Julie Collison | Physical Therapist | 1409 Swamp Rd, Green Bay, WI 54313-1475 | 2010-04-26 |
| 1447426929 | Developmental Steps By Fons | Physical Therapist | 4102 Foxwood Ct, Janesville, WI 53546-8887 | 2008-05-05 |
| 1821262700 | Patricia E Barina | Physical Therapist | 16185 Burleigh Pl, Brookfield, WI 53005-2851 | 2008-04-22 |
| 1114190618 | Nancy Ellen Reithel | Physical Therapist | 610 Westwood Drive, Onalaska, WI 54650 | 2008-04-07 |
| 1447421656 | Gail Ann May | Physical Therapist | 205 Lodi St, Lodi, WI 53555-1220 | 2008-03-14 |
| 1144410069 | Jill Marie Nelson | Physical Therapist | N10732 Newton Lake Rd, Athelstane, WI 54104-9629 | 2007-07-26 |
| 1215143524 | Debra R Reichl | Physical Therapist | Center for Blind and Visually Impaired Children, 5600 W Brown Deer Rd, Ste. 4, Milwaukee, WI 53223 | 2007-05-15 |
| Find all providers with the same taxonomy | ||||
| City | BROWN DEER |
| Zip Code | 53209 |
Please comment or provide details below to improve the information on LORI DOMINICZAK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.