Individual
PAUL F WILCZAK
Active
Individual
PAUL F WILCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PS006213L
PA
103TC0700X
Clinical Psychologist
Primary
PS006213L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001535250
—
PA
01
—
01096501
CAPITAL BLUE CROSS
PA
01
—
064396
VALUE OPTIONS
PA
01
—
1031360
CIGNA BEHAV HEALTH
PA
01
—
112012000
MAGELLAN
PA
01
—
131335
PA BLUE SHIELD
PA
01
—
434143
MAMSI
PA
01
—
P00074980
RAILROAD MEDICARE
PA
Enumeration date
06/28/2006
Last updated
08/11/2014
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