Dr Gary Daniel Kendziorski, PHD is a
Psychologist - Clinical based in Lannon, Wisconsin. Dr Gary Daniel Kendziorski is licensed to practice in Wisconsin (license number 1043-057) and his current practice location is
20943 W Good Hope Rd, Lannon, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(262) 250-3331.
NPI number for Dr Gary Daniel Kendziorski is 1730277617 and his current mailing address is 20943 W Good Hope Road, Lannon, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1730277617.
Healthcare Provider's Profile
| Full Name | Dr Gary Daniel Kendziorski |
|---|
| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 20943 W Good Hope Rd, Lannon, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1730277617
- Provider Enumeration Date: 10/10/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Dr Gary Daniel Kendziorski such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1730277617 | NPI | - | NPPES |
| 39043400 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | 1043-057 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Gary Daniel Kendziorski is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Gary Daniel Kendziorski, PHD
20943 W Good Hope Road,
Lannon, WI 53046
Ph: (262) 250-3331 | Dr Gary Daniel Kendziorski, PHD
20943 W Good Hope Rd,
Lannon, WI 53046-9770
Ph: (262) 250-3331 |
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