Provider Demographics
NPI:1366260010
Name:SZCZECHOWSKI, MICHAEL EVAN
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:EVAN
Last Name:SZCZECHOWSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 WILLOW CREEK LN
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-3422
Mailing Address - Country:US
Mailing Address - Phone:302-753-9392
Mailing Address - Fax:
Practice Address - Street 1:850 LIBRARY AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7170
Practice Address - Country:US
Practice Address - Phone:302-319-5161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program