Provider Demographics
NPI:1669684163
Name:MICHALIK, ANDRZEJ MARIA (MD)
Entity Type:Individual
Prefix:MR
First Name:ANDRZEJ
Middle Name:MARIA
Last Name:MICHALIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:560 CARDERO STREET
Mailing Address - Street 2:402
Mailing Address - City:VANCOUVER
Mailing Address - State:BRITISH COLUMBIA
Mailing Address - Zip Code:V6G3E9
Mailing Address - Country:CA
Mailing Address - Phone:604-681-6864
Mailing Address - Fax:
Practice Address - Street 1:72 SHAWNEE AVE
Practice Address - Street 2:#5
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-5165
Practice Address - Country:US
Practice Address - Phone:914-202-7581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1343982084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY134398OtherLICENSE