Provider Demographics
NPI:1629139100
Name:WAJNRAJCH, MICHAEL PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PAUL
Last Name:WAJNRAJCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:235 E 42ND ST
Mailing Address - Street 2:MS 685-18-17
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5703
Mailing Address - Country:US
Mailing Address - Phone:212-733-9918
Mailing Address - Fax:646-441-4488
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:SUITE 3C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-4141
Practice Address - Fax:212-263-8172
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY1885532080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01450320Medicaid
NJ6809707Medicaid
NJ6809707Medicaid
NYF72657Medicare UPIN