Provider Demographics
NPI:1043946445
Name:PHYSICIANSPECIALTYNETWORK PLLC
Entity Type:Organization
Organization Name:PHYSICIANSPECIALTYNETWORK PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:WILCZYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-490-4445
Mailing Address - Street 1:6073 VOLKMAN RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-6501
Mailing Address - Country:US
Mailing Address - Phone:814-490-4445
Mailing Address - Fax:
Practice Address - Street 1:6073 VOLKMAN RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-6501
Practice Address - Country:US
Practice Address - Phone:814-490-4445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty