Provider Demographics
NPI:1770696627
Name:SCHWAI, BERNADETTE M (MPT)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:M
Last Name:SCHWAI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:BERNADETTE
Other - Middle Name:M
Other - Last Name:MARSIGLIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4000 N. PROVIDENCE AVENUE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-8018
Mailing Address - Country:US
Mailing Address - Phone:920-257-2000
Mailing Address - Fax:920-257-2004
Practice Address - Street 1:209 SOLAR DR
Practice Address - Street 2:
Practice Address - City:WALKERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21793-8000
Practice Address - Country:US
Practice Address - Phone:240-439-5825
Practice Address - Fax:201-233-1234
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10323-024225100000X
MD19443225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40445600Medicaid
WIP00241145OtherRAILROAD MEDICARE