Provider Demographics
NPI:1366751893
Name:JEDNAK, KRZYSZTOF PAWEL (CASAC-T)
Entity type:Individual
Prefix:MR
First Name:KRZYSZTOF
Middle Name:PAWEL
Last Name:JEDNAK
Suffix:
Gender:M
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 GUION ST
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-4109
Mailing Address - Country:US
Mailing Address - Phone:914-378-7566
Mailing Address - Fax:914-965-0912
Practice Address - Street 1:8 GUION ST
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-4109
Practice Address - Country:US
Practice Address - Phone:914-378-7566
Practice Address - Fax:914-965-0912
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY24351101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)