NPIMap

Organization Active NPI

Robert M Woznicki MD PC

  • Psychiatry Physician
  • Port Jefferson, NY
National Provider Identifier
1285813667
Registry record updated Mar 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
177550 Issued in NY
Legal business name
ROBERT M WOZNICKI MD PC
Practice address
640 Belle Terre Rd
BLDG J3
Port Jefferson, NY 11777-1936
Phone
(631) 928-3184
Fax
(631) 928-3957
NPI assigned
Nov 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2013

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

Authorized official

Name
Dr. Robert Michael Woznicki, MDNPI 1366514978
Title
President
Phone
(631) 928-3184

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 177550 NY Primary

Addresses

Primary practice location

640 Belle Terre Rd
BLDG J3
Port Jefferson, NY 11777-1936

Mailing address

640 Belle Terre Rd
Suite 3 BLD J
Port Jefferson, NY 11777-1936
Phone (631) 928-3184

National Provider Directory

National Provider Directory

Locations

640 Belle Terre Rd
Ste J3
Port Jefferson, NY 11777
Phone (631) 928-3184

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363132800000",
    "number": "1285813667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 BELLE TERRE RD",
            "address_2": "SUITE 3 BLD J",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771936",
            "telephone_number": "631-928-3184",
            "fax_number": "631-928-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 BELLE TERRE RD",
            "address_2": "BLDG J3",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771936",
            "telephone_number": "631-928-3184",
            "fax_number": "631-928-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT M WOZNICKI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-01",
        "last_updated": "2013-03-13",
        "status": "A",
        "authorized_official_last_name": "WOZNICKI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-928-3184",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "177550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; 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.