Kathleen Wieczorek

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

OS006523L Issued in PA

Legal business name

KATHLEEN WIECZOREK

Practice address

5050 W Ridge Rd FL 2
Erie, PA 16506-1216

Phone

(814) 836-3900

NPI assigned

Jul 8, 2008

Last updated

Jul 8, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Barb Beckett

Title

Billing Specialist

Phone

(330) 386-9300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1205099421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 W RIDGE RD FL 2",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165061216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 W RIDGE RD FL 2",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165061216",
            "telephone_number": "814-836-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHLEEN WIECZOREK",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "BECKETT",
        "authorized_official_first_name": "BARB",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "330-386-9300"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "OS006523L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016175890009",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mark Kevin Kauffman, DO
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• Alyssa Christine Kaveney, RN
• Brian E Kaveney, OTR

• Clinical Medical Laboratory in Erie, PA
• Providers in Erie, PA by specialty
• Clinical Medical Laboratory in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.