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NPI Code Detail

MEDICARE: AGNIESZKA MICHALIK PA-C

MEDICARE: AGNIESZKA MICHALIK PA-C
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
1363A00000XPhysician Assistant023173-1NY

General Provider Information

NPI Number : 1427614924
Entity Type Code : Individual
Provider Name (Legal Business Name) : AGNIESZKA MICHALIK PA-C
Provider Business Mailing Address
First Line : 24 IRVING AVE
Second Line :
City : FLORAL PARK
State : NY
Zip : 11001-1624
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2701 QUEENS PLZ N FL 10
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101-4022
Country : US
Telephone Number : 212-283-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2019
Last Update Date : 05/10/2019

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