Provider Demographics
NPI:1891759155
Name:BARTOSZEK, JOSEPH JR JR (PA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JR
Last Name:BARTOSZEK
Suffix:JR
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3249
Mailing Address - Street 2:HEALTH WISE MEDICAL ASSOCIATES
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-2149
Mailing Address - Country:US
Mailing Address - Phone:860-872-2289
Mailing Address - Fax:860-896-1425
Practice Address - Street 1:29 NAEK RD
Practice Address - Street 2:HEALTH WISE MEDICAL ASSOCIATES SUITE 5
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066
Practice Address - Country:US
Practice Address - Phone:860-872-2289
Practice Address - Fax:860-896-1425
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1347363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AP1696Medicare ID - Type Unspecified
MAS02423Medicare UPIN