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General NPI Number Information
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NPI Number | 1932943685
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Entity Type | Individual
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Provider Name | ALEKSANDRA MARIA CZYZ OD
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Gender | Female
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Dates
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Enumeration Date | 06/19/2024
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 2520 MILTON AVE SPC 150
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City | JANESVILLE
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State | WI
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Zip | 53545-0442
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Country | US
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Telephone | 608-757-2633
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Fax |
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Provider Business Mailing Address
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Address Line | 2738 PARK PLACE LN APT 48
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City | JANESVILLE
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State | WI
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Zip | 53545-5267
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Country | US
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Telephone | 773-993-6070
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4020-35
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License Number State | WI
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