Provider Demographics
NPI:1598572414
Name:WOZNIAK, KYLE
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:WOZNIAK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-3462
Mailing Address - Country:US
Mailing Address - Phone:786-805-7335
Mailing Address - Fax:
Practice Address - Street 1:3700 LANCASTER PIKE STE 105
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-1511
Practice Address - Country:US
Practice Address - Phone:302-842-2390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist