Provider Demographics
NPI:1447228937
Name:TRZECIAK, VICTOR J (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:J
Last Name:TRZECIAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5334 MEADOW LANE CT
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44035-1469
Mailing Address - Country:US
Mailing Address - Phone:440-934-5454
Mailing Address - Fax:440-934-8999
Practice Address - Street 1:5334 MEADOW LANE CT
Practice Address - Street 2:
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44035-1469
Practice Address - Country:US
Practice Address - Phone:440-934-5454
Practice Address - Fax:440-934-8999
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.052395207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0674257Medicaid
OH0598695Medicare ID - Type Unspecified
OH0674257Medicaid