Provider Demographics
NPI:1104300086
Name:VOJNYK, CHARLENE LOUISE
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:LOUISE
Last Name:VOJNYK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2477 COUNTY RD 516
Mailing Address - Street 2:STE 103
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-4603
Mailing Address - Country:US
Mailing Address - Phone:732-952-8222
Mailing Address - Fax:732-952-8221
Practice Address - Street 1:546 SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2542
Practice Address - Country:US
Practice Address - Phone:732-381-3642
Practice Address - Fax:732-396-4463
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2021-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00857400207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ00857400OtherNJ MEDICAL LICENSE