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NPI Code Detail

MEDICARE: MR. DANIEL VICTOR KRSTESKI LLMSW

MEDICARE: MR. DANIEL VICTOR KRSTESKI LLMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801092540MI

General Provider Information

NPI Number : 1093024523
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DANIEL VICTOR KRSTESKI LLMSW
Provider Business Mailing Address
First Line : 1410 E 14 MILE RD
Second Line : SUITE 900
City : MADISON HEIGHTS
State : MI
Zip : 48071-1541
Country : US
Telephone Number : 248-524-8801
Fax Number :
Provider Business Practice Location Address
First Line : 1410 E 14 MILE RD
Second Line : SUITE 900
City : MADISON HEIGHTS
State : MI
Zip : 48071-1541
Country : US
Telephone Number : 248-524-8801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2010
Last Update Date : 10/01/2010

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