Provider Demographics
NPI:1174702062
Name:GREBOWSKY, BRET JOSEPH (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRET
Middle Name:JOSEPH
Last Name:GREBOWSKY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9420 KEY WEST AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6332
Mailing Address - Country:US
Mailing Address - Phone:301-545-1677
Mailing Address - Fax:301-545-1675
Practice Address - Street 1:9420 KEY WEST AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6332
Practice Address - Country:US
Practice Address - Phone:301-545-1677
Practice Address - Fax:301-545-1675
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18894225100000X, 2251H1200X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD007576R15Medicare PIN