Provider Demographics
NPI:1275656944
Name:STUART JOSEPH SURKOSKY
Entity Type:Organization
Organization Name:STUART JOSEPH SURKOSKY
Other - Org Name:CARE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SURKOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-789-9797
Mailing Address - Street 1:837 EVANS CITY RD
Mailing Address - Street 2:#202
Mailing Address - City:RENFREW
Mailing Address - State:PA
Mailing Address - Zip Code:16053-9205
Mailing Address - Country:US
Mailing Address - Phone:724-789-9797
Mailing Address - Fax:724-789-9910
Practice Address - Street 1:837 EVANS CITY RD
Practice Address - Street 2:#202
Practice Address - City:RENFREW
Practice Address - State:PA
Practice Address - Zip Code:16053-9205
Practice Address - Country:US
Practice Address - Phone:724-789-9797
Practice Address - Fax:724-789-9910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005245111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1858573OtherASSIGNMENT ACCOUNT NUMBER
PA068545Medicare ID - Type UnspecifiedGROUP NUMBER