Provider Demographics
NPI:1568407062
Name:WRZESZCZ-ONYENMA, KAROLINA (MD)
Entity Type:Individual
Prefix:
First Name:KAROLINA
Middle Name:
Last Name:WRZESZCZ-ONYENMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 JAMES TRIMBLE BLVD
Mailing Address - Street 2:PO BOX 678
Mailing Address - City:PAINTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41240-1055
Mailing Address - Country:US
Mailing Address - Phone:606-789-6844
Mailing Address - Fax:606-789-4157
Practice Address - Street 1:625 JAMES TRIMBLE BLVD
Practice Address - Street 2:
Practice Address - City:PAINTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41240-1055
Practice Address - Country:US
Practice Address - Phone:606-789-3511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253141207L00000X
KY38800207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3309558Medicare UPIN