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Contact Information

CHARLES A WASICEK, MD
145 CLINTON STREET
WATERTOWN, NY13601
 Phone: 315-782-5523
 Fax: 315-782-0549
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rheumatology

207RR0500X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for CHARLES A WASICEK · (Male)

NPI Number 1619049038
Status Active
Credentials MD
Entity Individual
Enumeration date 11/14/2006
Last updated 05/19/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 122206
  • NY Medicaid 00875434MC
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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