Provider Demographics
NPI:1053121301
Name:STRZYZEWSKI, KAMIL
Entity type:Individual
Prefix:
First Name:KAMIL
Middle Name:
Last Name:STRZYZEWSKI
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 1:833 LOMAS BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-1955
Mailing Address - Country:US
Mailing Address - Phone:505-247-7492
Mailing Address - Fax:505-422-4232
Practice Address - Street 1:833 LOMAS BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-1955
Practice Address - Country:US
Practice Address - Phone:505-247-7492
Practice Address - Fax:505-422-4232
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker