MEDICARE: PIOTR JURGIELEWICZ

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207P00000X	Emergency Medicine Physician	65883	AZ

General Provider Information

NPI Number	:	1891356028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PIOTR JURGIELEWICZ

Provider Business Mailing Address
First Line	:	1 MEDICAL CENTER BLVD
Second Line	:
City	:	CHESTER
State	:	PA
Zip	:	19013-3902
Country	:	US
Telephone Number	:	610-447-6671
Fax Number	:

Provider Business Practice Location Address
First Line	:	7401 S WILMOT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85756-8803
Country	:	US
Telephone Number	:	520-493-0499
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2019
Last Update Date	:	11/13/2024

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Directions to “ PIOTR JURGIELEWICZ ” Practice Location

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