Provider Demographics
NPI:1326496514
Name:TOMASZEWICZ, MICHAL JAN (PMHNP)
Entity Type:Individual
Prefix:MR
First Name:MICHAL
Middle Name:JAN
Last Name:TOMASZEWICZ
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 LOCUST GROVE RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-6928
Mailing Address - Country:US
Mailing Address - Phone:302-354-5424
Mailing Address - Fax:
Practice Address - Street 1:410 FOULK RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3820
Practice Address - Country:US
Practice Address - Phone:302-478-6199
Practice Address - Fax:302-354-7162
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL8-0000143363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health