Organization
JOHN J. WASNIEWSKI JR. DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN JOSEPH WASNIEWSKI DO (PRESIDENT)
(215) 271-0101
Entity
Organization
Contact information
Practice address
2136 W PASSYUNK AVE, PHILADELPHIA, PA 19145-3415
(215) 271-0101
(215) 334-7259
Mailing address
2136 W PASSYUNK AVE, PHILADELPHIA, PA 19145-3415
(215) 271-0101
(215) 334-7259
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005923960004
—
PA
01
—
107718
MEDICARE ID
PA
01
—
1598762402
NPI PRIVATE PROVIDER
PA
Enumeration date
03/06/2007
Last updated
03/27/2008
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