Charles P Wajszczuk, M.D.

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

25MA03943800 Issued in NJ

Practice address

199 Grandview Rd
SC-137
Skillman, NJ 08558-1311

Phone

(908) 874-1450

Fax

(908) 904-3862

NPI assigned

Jun 30, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Charles P Wajszczuk Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1760644819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 GRANDVIEW RD",
            "address_2": "SC-137",
            "city": "SKILLMAN",
            "state": "NJ",
            "postal_code": "085581311",
            "telephone_number": "908-874-1450",
            "fax_number": "908-904-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 GRANDVIEW RD",
            "address_2": "SC-137",
            "city": "SKILLMAN",
            "state": "NJ",
            "postal_code": "085581311",
            "telephone_number": "908-874-1450",
            "fax_number": "908-904-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAJSZCZUK",
        "first_name": "CHARLES",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NJ",
            "license": "25MA03943800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD",
            "identifier": "25MA03943800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLES",
            "last_name": "WAJSZCZUK",
            "middle_name": "P",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Community Health Worker in Skillman, NJ
• Providers in Skillman, NJ by specialty
• Community Health Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.