Individual
KRAIG KENNETH WASIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
47 NEW SCOTLAND AVENUE, DEPT OF EMERGENCY MEDICINE, ALBANY, NY 12208
(518) 262-4050
Mailing address
1100 MARSHALL WAY DEPT OF, PLACERVILLE, CA 95667-6533
(530) 622-1441
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
17357
CA
390200000X
Student in an Organized Health Care Education/Training Program
63818
NY
Other
Enumeration date
04/08/2016
Last updated
07/09/2019
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