Provider Demographics
NPI:1679524573
Name:WOZNIAK, TIMOTHY F (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:F
Last Name:WOZNIAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:4701 OGLETOWN STANTON RD
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2055
Mailing Address - Country:US
Mailing Address - Phone:302-731-7782
Mailing Address - Fax:302-738-5917
Practice Address - Street 1:4701 OGLETOWN STANTON RD
Practice Address - Street 2:SUITE 2400
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2055
Practice Address - Country:US
Practice Address - Phone:302-731-7782
Practice Address - Fax:302-738-5917
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC10000964207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001470950008Medicaid
DE0000109001Medicaid
MD0431201501Medicaid
PA001470950008Medicaid
PA056084QEGMedicare PIN
MD0431201501Medicaid
DE0000109001Medicaid