Provider Demographics
NPI:1053327106
Name:CESANEK, JOSEPH E (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:CESANEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 MALE RD
Mailing Address - Street 2:
Mailing Address - City:WIND GAP
Mailing Address - State:PA
Mailing Address - Zip Code:18091-1513
Mailing Address - Country:US
Mailing Address - Phone:610-654-1000
Mailing Address - Fax:610-654-1004
Practice Address - Street 1:951 MALE RD
Practice Address - Street 2:
Practice Address - City:WIND GAP
Practice Address - State:PA
Practice Address - Zip Code:18091-1513
Practice Address - Country:US
Practice Address - Phone:610-654-1000
Practice Address - Fax:610-654-1004
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050878L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00295814OtherRAILROAD MEDICARE
PAP00295814OtherRAILROAD MEDICARE
NJ050507Medicare PIN
PA085670Medicare PIN