Provider Demographics
NPI:1700073889
Name:CHMIELINSKI, MARK A (RRT, LRCP)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:A
Last Name:CHMIELINSKI
Suffix:
Gender:M
Credentials:RRT, LRCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 LANGE DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-4625
Mailing Address - Country:US
Mailing Address - Phone:248-250-2474
Mailing Address - Fax:
Practice Address - Street 1:325 LANGE DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-4625
Practice Address - Country:US
Practice Address - Phone:248-250-2474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI44010003492279H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health