NPI 1952943649

Alexander Porucznik

Practitioner Specialist Valparaiso, IN

Practice location

Address: 1861 Sturdy Rd, Valparaiso, IN 46383-8017
Phone: (219) 548-0360
Mailing address: 565 W Quincy St Unit 617, Chicago, IL 60661-2903

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 10002834A (IN)

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Registry record

NPI: 1952943649
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Oct 2019
Record last updated: 8 Apr 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.