Provider Demographics
NPI:1811024359
Name:DR. ALEKSANDRA WILANOWSKI AND ASSOCIATES P.C.
Entity Type:Organization
Organization Name:DR. ALEKSANDRA WILANOWSKI AND ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST , PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEKSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILANOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:734-432-6066
Mailing Address - Street 1:17177 N LAUREL PARK DR
Mailing Address - Street 2:SUITE 437
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-2693
Mailing Address - Country:US
Mailing Address - Phone:734-432-6066
Mailing Address - Fax:734-432-6077
Practice Address - Street 1:17177 N LAUREL PARK DR
Practice Address - Street 2:SUITE 437
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2693
Practice Address - Country:US
Practice Address - Phone:734-432-6066
Practice Address - Fax:734-432-6077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013326103T00000X
MI43010660242084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH 10564Medicare UPIN
MION38830Medicare ID - Type Unspecified