Wasiczko, Robert

Wasiczko, Robert is an individual health care provider with primary practice located at 1656 Champlin Ave , Utica NY 13502. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Wasiczko, Robert can be contacted via phone (315) 624-4090.

Contact Information

Primary practice address
1656 Champlin Ave Utica NY 13502
Phone: (315) 624-4090
Fax: (315) 624-4095
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 183436 New York

Profile Details

NPI number 1356394191
LBN Legal business name Wasiczko, Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated Oct 6th, 2016 - about 9 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 1356394191 NPPES
New York MEDICAID 01246377

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