Individual
DR. THOMAS NICHOLAS CZARNECKI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
N112W15415 MEQUON RD, GERMANTOWN, WI 53022-3410
(262) 250-7800
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(262) 250-7800
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
025-519
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43205100
—
WI
Enumeration date
11/23/2006
Last updated
06/12/2012
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