Provider Demographics
NPI:1700425584
Name:WASIK, MONIKA KATHERINE (MSN, WHNP-BC, CBC)
Entity Type:Individual
Prefix:MS
First Name:MONIKA
Middle Name:KATHERINE
Last Name:WASIK
Suffix:
Gender:F
Credentials:MSN, WHNP-BC, CBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2243 CATHARINE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1703
Mailing Address - Country:US
Mailing Address - Phone:610-772-5812
Mailing Address - Fax:
Practice Address - Street 1:800 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-4717
Practice Address - Country:US
Practice Address - Phone:215-339-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021048363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health