Provider Demographics
NPI:1124417811
Name:PRZYBYLOWICZ, JOSEPH (LMT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:PRZYBYLOWICZ
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 W UNION BLVD
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-3708
Mailing Address - Country:US
Mailing Address - Phone:610-865-1418
Mailing Address - Fax:
Practice Address - Street 1:623 W UNION BLVD
Practice Address - Street 2:SUITE 1B
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-3708
Practice Address - Country:US
Practice Address - Phone:610-865-1418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-18
Last Update Date:2015-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG000324174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist