Provider Demographics
NPI:1033195292
Name:ORLOSKI, JOAN M (PHD, DO)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:M
Last Name:ORLOSKI
Suffix:
Gender:F
Credentials:PHD, DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DURYEA
Mailing Address - State:PA
Mailing Address - Zip Code:18642-1027
Mailing Address - Country:US
Mailing Address - Phone:570-457-7192
Mailing Address - Fax:570-457-1901
Practice Address - Street 1:100 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:PA
Practice Address - Zip Code:18407-2170
Practice Address - Country:US
Practice Address - Phone:570-281-1485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2009-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0S004928L207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA115433OtherHIGHMARK BLUE SHIELD
PA0011481490006Medicaid
PA930090996OtherRAILROAD MEDICARE
PA001148149Medicaid
PA0011481490006Medicaid
PA001148149Medicaid
PAB36996Medicare UPIN