Provider Demographics
NPI:1649753922
Name:BARDZILOWSKI, SYDNEY SUZANNE (PT, DPT)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:SUZANNE
Last Name:BARDZILOWSKI
Suffix:
Gender:F
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 1:313 E PALMYRA AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2047
Mailing Address - Country:US
Mailing Address - Phone:714-408-8071
Mailing Address - Fax:
Practice Address - Street 1:3626 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-3847
Practice Address - Country:US
Practice Address - Phone:714-744-4400
Practice Address - Fax:714-744-4450
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA295518225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist