Healthcare Provider Details

I. General information

NPI: 1457750424
Provider Name (Legal Business Name): KATARZYNA CZERWINSKA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2014
Last Update Date: 10/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7165 COLUMBIA GATEWAY DR
COLUMBIA MD
21046-2539
US

IV. Provider business mailing address

10097 BALTIMORE NATIONAL PIKE
ELLICOTT CITY MD
21042-3611
US

V. Phone/Fax

Practice location:
  • Phone: 410-290-1054
  • Fax:
Mailing address:
  • Phone: 443-973-3339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22555
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: