Provider Demographics
NPI:1598868184
Name:WOZNIAK, RONALD F (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:F
Last Name:WOZNIAK
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 1:629 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090
Mailing Address - Country:US
Mailing Address - Phone:908-233-5264
Mailing Address - Fax:908-233-1223
Practice Address - Street 1:629 E BROAD ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090
Practice Address - Country:US
Practice Address - Phone:908-233-5264
Practice Address - Fax:908-233-1223
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2013-10-22
Deactivation Date:2013-08-23
Deactivation Code:
Reactivation Date:2013-10-22
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03204700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1324704Medicaid
C53862Medicare UPIN
NJ1324704Medicaid