| Edward J Wojniak, Jr, Inc. | |
|
4041 N High St Ste 203e Columbus OH 43214-3253 | |
| (614) 696-9900 | |
| (614) 696-9901 |
| Full Name | Edward J Wojniak, Jr, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 4041 N High St Ste 203e, Columbus, Ohio |
| Authorized Official Name and Position | Edward John Wojniak (PRESIDENT) |
| Authorized Official Contact | 6146969900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward J Wojniak, Jr, Inc. 96 W Kenworth Rd Columbus OH 43214-4008 Ph: (614) 696-9900 | Edward J Wojniak, Jr, Inc. 4041 N High St Ste 203e Columbus OH 43214-3253 Ph: (614) 696-9900 |
| NPI Number | 1427216464 |
|---|---|
| Provider Enumeration Date | 05/27/2008 |
| Last Update Date | 07/02/2024 |
| Certification Date | 07/02/2024 |
| Medicare PECOS PAC ID | 3678604139 |
|---|---|
| Medicare Enrollment ID | O20100626000524 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427216464 | NPI | - | NPPES |
| 1285792077 | Medicaid | OH | |
| 2513195 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Edward J Wojniak |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285792077 PECOS PAC ID: 4486621489 Enrollment ID: I20040910000239 |
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