Provider Demographics
NPI:1780602896
Name:VETERANS AFFAIS MEDICAL CENTER
Entity type:Organization
Organization Name:VETERANS AFFAIS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:PENDZISZEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:269-966-5600
Mailing Address - Street 1:PO BOX 117
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:MI
Mailing Address - Zip Code:49012-0117
Mailing Address - Country:US
Mailing Address - Phone:269-668-5467
Mailing Address - Fax:
Practice Address - Street 1:5500 ARMSTRONG ROAD
Practice Address - Street 2:VAMC 515 / PSYCHOLOGY SERVICE 116B
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015
Practice Address - Country:US
Practice Address - Phone:269-966-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008704283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital