Provider Demographics
NPI:1982610010
Name:WENDOLOWSKI, JOSEPH (DPM)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:WENDOLOWSKI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17425 OCEAN ONE PLZ UNIT 1
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1726
Mailing Address - Country:US
Mailing Address - Phone:302-297-8431
Mailing Address - Fax:302-433-6547
Practice Address - Street 1:17425 OCEAN ONE PLZ UNIT 1
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958
Practice Address - Country:US
Practice Address - Phone:302-297-8431
Practice Address - Fax:302-433-6547
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEE1-0000243213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3325407Medicaid
U79770Medicare UPIN
NJ3325407Medicaid