CHARLES WISNIEWSKI D.O. – NPI #1770997587
Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
CHARLES WISNIEWSKI is an AHC clinic located in PHILADELPHIA, PA. NPPES has assigned the NPI number 1770997587 to CHARLES WISNIEWSKI on June 19, 2014. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QM0855X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Adolescent and Children Mental Health
The NPI profile was previously updated about 8 years ago on Oct 12, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CHARLES WISNIEWSKI below.
NPI Profile for
CHARLES WISNIEWSKI
(about 12 years ago)
PHILADELPHIA, PA 19124-2343 Phone: (215) 831-2600 Fax:
1 Other location(s):
Bryn Mawr, PA 19010-3121
Phone: (484) 337-4286
Fax: (484) 337-4293
PHILADELPHIA, PA 19124-2343 Phone: (631) 831-4053 Fax:
Identifiers for CHARLES WISNIEWSKI
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| MEDICAID | PA | 1770997587 |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 261QM0855X - Clinic/Center / Adolescent and Children Mental Health (Primary) |
||
| 2084P0800X - Psychiatry & Neurology / Psychiatry |
PA | OS019121 |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.
Additional Information
- Refer to Part B
- Order Durable Medical Equipment
- Refer to Home Health Agency
- Order Power Mobility Devices
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