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Individual
PETER LUKASZ WILCZANSKI
Active
Individual
PETER LUKASZ WILCZANSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD040751L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025573901
UNIVERA
NY
05
—
0011180320003
—
PA
01
—
015973
BLUE SHIELD
PA
01
—
01917019
NY MEDICAID
NY
01
—
080081947
RR MEDICARE
PA
01
—
212709
UPMC
PA
01
—
522615
AETNA
PA
01
—
66429
UNISON
PA
01
—
P000383
GATEWAY
PA
Enumeration date
10/10/2005
Last updated
05/15/2008
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