Provider Demographics
NPI:1346219300
Name:JUSZCZYK, MONIKA ANNA (MD)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:ANNA
Last Name:JUSZCZYK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2165 ROUTE 908
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-2955
Mailing Address - Country:US
Mailing Address - Phone:860-462-3737
Mailing Address - Fax:
Practice Address - Street 1:333 W MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SAXONBURG
Practice Address - State:PA
Practice Address - Zip Code:16056-2254
Practice Address - Country:US
Practice Address - Phone:860-462-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432887207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102156836Medicaid
PA102156836Medicaid
PA123564NHMMedicare PIN