Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Etienne Joseph Mickiewicz

Individual provider Physical Therapist · NPI 1356290167

Etienne Joseph Mickiewicz is a Physical Therapist in Private Practice in Newark, Delaware. Qualified in 2025, 1 year ago. Practices with Ud Health LLC, a 54-clinician group and accepts Medicare assignment. Licensed in Delaware.

Years since qualifying
1
Licensed in
DE
In the registry since
2026
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Practice location Address checks out

540 S College Ave Ste 160
Newark, DE 19713-1302
Phone: (302) 831-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence J1-0015139 (DE)

Record details

NPI number1356290167
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 26, 2026
Last updated in NPPESJanuary 26, 2026
Certification dateJanuary 25, 2026
Mailing address54 Cheswold Blvd Apt 303, Newark, DE 19713-4160

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Ud Health Llc — 54 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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