Provider Demographics
NPI:1093382277
Name:UNGVARSKY, JOSEPH JR (PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:UNGVARSKY
Suffix:JR
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 MAPLE AVE STE 15
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-1460
Mailing Address - Country:US
Mailing Address - Phone:570-253-8219
Mailing Address - Fax:
Practice Address - Street 1:600 MAPLE AVE STE 15
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-1460
Practice Address - Country:US
Practice Address - Phone:570-253-8219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023833363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health