Czerniak, Matthew T

Czerniak, Matthew T is an individual health care provider with primary practice located at 3801 Spring St , Racine WI 53405-1667. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Czerniak, Matthew T can be contacted via phone (262) 687-4479.

Contact Information

Primary practice address
3801 Spring St Racine WI 53405-1667
Phone: (262) 687-4479
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2489-023 Wisconsin

Profile Details

NPI number 1104058528
LBN Legal business name Czerniak, Matthew T
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2009
Last updated Aug 18th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104058528 NPPES
Wisconsin Other 2489-023 WISCONSIN LICENSE

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