Individual ProviderMaria RoszczenkoPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address5820 N Lilley Rd, Ste 6, Canton, MI 48187-3691(734) 404-5856PECOS EnrollmentBased on the most recent information from CMS, provider Maria Roszczenko does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1780721761Provider TypeIndividualFull NameRoszczenko, MariaCredentialP.T.GenderFemaleSole ProprietorYesEnumeration Date1/31/2007Last Updated5/9/2018Contact InformationPractice LocationPractice Address5820 N Lilley Rd, Ste 6, Canton, MI 48187-3691Phone(734) 404-5856Fax(734) 273-9361Mailing LocationMailing Address5820 N Lilley Rd, Ste 6, Canton, MI 48187-3691Phone(734) 404-5856Fax(734) 273-9361Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense5501012986MichiganProvider IdentifiersIDDescriptionIssuerIDP00100555DescriptionOtherIssuerMEDICARE RAILROADMichiganID0N58620DescriptionOtherIssuerHAPMichiganID7543420DescriptionOtherIssuerAETNAMichiganID16869DescriptionOtherIssuerM-CAREMichiganID0H20094DescriptionOtherIssuerBCBSMichiganID500573DescriptionOtherIssuerCARE CHOICESMichigan