Healthcare Provider Details

I. General information

NPI: 1841127776
Provider Name (Legal Business Name): KATARZYNA KOCHANIEWICZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 MCAULEY DR RM 3001
YPSILANTI MI
48197-1097
US

IV. Provider business mailing address

32235 HARVARD ST
WESTLAND MI
48186-4984
US

V. Phone/Fax

Practice location:
  • Phone: 734-712-8100
  • Fax:
Mailing address:
  • Phone: 586-713-3676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601013569
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: