Wacendak, John
Wacendak, John is an individual health care provider with primary practice located at 40 Arch St , Johnson City NY 13790-2102. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wacendak, John can be contacted via phone (607) 763-6075.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 194762 | New York |
Profile Details
| NPI number | 1932196284 |
|---|---|
| LBN Legal business name | Wacendak, John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 3rd, 2005 |
| Last updated | Nov 19th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932196284 | NPPES |
| New York | MEDICAID | 01565544 |
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