Provider Demographics
NPI:1285849919
Name:LAHNOVYCH, VICTOR (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:
Last Name:LAHNOVYCH
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 1:90 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:EMPORIUM
Mailing Address - State:PA
Mailing Address - Zip Code:15834-1302
Mailing Address - Country:US
Mailing Address - Phone:814-486-1115
Mailing Address - Fax:814-486-0404
Practice Address - Street 1:90 E 2ND ST
Practice Address - Street 2:
Practice Address - City:EMPORIUM
Practice Address - State:PA
Practice Address - Zip Code:15834-1302
Practice Address - Country:US
Practice Address - Phone:814-486-1115
Practice Address - Fax:814-486-0404
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD456126207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVWV0422B662Medicare Oscar/Certification
WVWV0422EMedicare Oscar/Certification
WVWV0422B663Medicare Oscar/Certification
WVWV0422DMedicare Oscar/Certification
WVWV0422BMedicare Oscar/Certification
WVWV0422HMedicare Oscar/Certification
WV2029921Medicare PIN
WVWV0422FMedicare Oscar/Certification
WVWV0422GMedicare Oscar/Certification
WV2029921Medicare PIN
WVWV0422FMedicare Oscar/Certification
WVWV0422GMedicare Oscar/Certification