MEDICARE: PATRICK A. KRZYZEWSKI, D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier	477-25	WI
2	332BC3200X	Customized Equipment (DME)	477-25	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1053496067	OTHER		NPI-PRACTITIONER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407159692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRICK A. KRZYZEWSKI, D.P.M.

Provider Business Mailing Address
First Line	:	7635 W OKLAHOMA AVE
Second Line	:	SUITE 110
City	:	MILWAUKEE
State	:	WI
Zip	:	53219-3600
Country	:	US
Telephone Number	:	414-546-3100
Fax Number	:	414-546-1881

Provider Business Practice Location Address
First Line	:	7635 W OKLAHOMA AVE
Second Line	:	SUITE 110
City	:	MILWAUKEE
State	:	WI
Zip	:	53219-3600
Country	:	US
Telephone Number	:	414-546-3100
Fax Number	:	414-546-1881

Authorized Official
Title or Position	:	CEO
Name	:	DR. PATRICK ALBERT KRZYZEWSKI
Credential	:	D.P.M.
Telephone Number	:	414-546-3100

Provider Enumeration Date	:	12/10/2010
Last Update Date	:	03/07/2023

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