Provider Demographics
NPI:1639830417
Name:CENDROWSKI, ERIC KENNETH (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:KENNETH
Last Name:CENDROWSKI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3247 THOMAS AVE
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-1164
Mailing Address - Country:US
Mailing Address - Phone:313-310-0405
Mailing Address - Fax:
Practice Address - Street 1:3247 THOMAS AVE
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-1164
Practice Address - Country:US
Practice Address - Phone:313-310-0405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program