KAMIL POTACZALA - NPI 1124814116 - Student in an Organized Health Care Education/Training Program in Petersburg, VA

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

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About Kamil Potaczala NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAMIL POTACZALA (NPI 1124814116) is an individual student in an organized health care education/training program in Petersburg, Virginia and active in the NPI registry since April 2025.

NPPES Registry Identity

NPI1124814116

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameKAMIL POTACZALA

Location Address200 MEDICAL PARK BLVDPetersburg, VA 23805-9274

Mailing Address200 W Edge Way Apt 4301Lynchburg, VA 24502-5873 · (646) 382-3201

Phone(804) 765-5000

Sole ProprietorYes

Enumeration DateApril 16, 2025

NPPES CertifiedApril 16, 2025

✔ NPI 1124814116 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

200 MEDICAL PARK BLVD, Petersburg, VA 23805

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