Provider Demographics
NPI:1053591487
Name:MIERZEJEWSKI, SYDNEY LEIGH
Entity type:Individual
Prefix:MS
First Name:SYDNEY
Middle Name:LEIGH
Last Name:MIERZEJEWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 BOSTON POST RD E STE 150
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3527
Mailing Address - Country:US
Mailing Address - Phone:508-624-0304
Mailing Address - Fax:
Practice Address - Street 1:221 BOSTON POST RD E STE 150
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3527
Practice Address - Country:US
Practice Address - Phone:508-624-0304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist