Provider Demographics
NPI:1750685772
Name:RONALD F WOZNIAK MDPA
Entity type:Organization
Organization Name:RONALD F WOZNIAK MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:F
Authorized Official - Last Name:WOZNIAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-233-5264
Mailing Address - Street 1:629 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2117
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:07090-2117
Practice Address - Country:US
Practice Address - Phone:908-233-5264
Practice Address - Fax:908-233-1223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2013-10-25
Deactivation Date:2013-08-23
Deactivation Code:
Reactivation Date:2013-10-25
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty