Healthcare Provider Details

I. General information

NPI: 1063992550
Provider Name (Legal Business Name): TERESA PALUSZCYK BARNWELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TERESA LIEKO PALUSZCYK MD

II. Dates (important events)

Enumeration Date: 08/15/2018
Last Update Date: 08/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13232 N 14TH PL
PHOENIX AZ
85022-4901
US

IV. Provider business mailing address

PO BOX 9818
PHOENIX AZ
85068-9818
US

V. Phone/Fax

Practice location:
  • Phone: 602-863-9922
  • Fax:
Mailing address:
  • Phone: 602-978-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086H0002X
TaxonomyHospice and Palliative Medicine (Surgery) Physician
License Number23032
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: