Provider Demographics
NPI:1871580084
Name:CZYZEWSKI, WILLIAM ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ANTHONY
Last Name:CZYZEWSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CARMICHAELS
Mailing Address - State:PA
Mailing Address - Zip Code:15320-1226
Mailing Address - Country:US
Mailing Address - Phone:724-966-7277
Mailing Address - Fax:724-966-7261
Practice Address - Street 1:200 N MARKET ST
Practice Address - Street 2:
Practice Address - City:CARMICHAELS
Practice Address - State:PA
Practice Address - Zip Code:15320-1226
Practice Address - Country:US
Practice Address - Phone:724-966-7277
Practice Address - Fax:724-966-7261
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006916L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01625400Medicaid
PACZ666295OtherBC/BS
PA200042OtherUPMC
PA200042OtherUPMC
PAU65099Medicare UPIN