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General NPI Number Information
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NPI Number | 1669684163
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Entity Type | Individual
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Provider Name | ANDRZEJ MARIA MICHALIK M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 72 SHAWNEE AVE #5
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City | YONKERS
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State | NY
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Zip | 10710-5165
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Country | US
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Telephone | 914-202-7581
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Fax |
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Provider Business Mailing Address
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Address Line | 560 CARDERO STREET 402
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City | VANCOUVER
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State | BRITISH COLUMBIA
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Zip | V6G3E9
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Country | CA
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Telephone | 604-681-6864
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0015X
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Taxonomy Name | Psychosomatic Medicine Physician
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License Number | 134398
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License Number State | NY
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