Provider Demographics
NPI:1073912564
Name:NOWACKI, DARYL JAMES (PA)
Entity Type:Individual
Prefix:MR
First Name:DARYL
Middle Name:JAMES
Last Name:NOWACKI
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:5106 N PIONEER RD
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9642
Mailing Address - Country:US
Mailing Address - Phone:814-688-8470
Mailing Address - Fax:
Practice Address - Street 1:9100 BABCOCK BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5815
Practice Address - Country:US
Practice Address - Phone:412-367-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical