Healthcare Provider Details

I. General information

NPI: 1093177446
Provider Name (Legal Business Name): WAUKESHA COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2016
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 W MORELAND BLVD MEDICAL EXAMINER
WAUKESHA WI
53188-2428
US

IV. Provider business mailing address

515 W MORELAND BLVD
WAUKESHA WI
53188-2428
US

V. Phone/Fax

Practice location:
  • Phone: 262-548-7575
  • Fax: 262-896-8079
Mailing address:
  • Phone: 262-548-7575
  • Fax: 262-896-8079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LYNDA BIEDRZYCKI
Title or Position: MEDICAL EXAMINER
Credential: M.D.
Phone: 262-548-7575