Provider Demographics
NPI:1376543165
Name:DRAPIEWSKI, VINCENT A (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:A
Last Name:DRAPIEWSKI
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 1:166 HANOVER ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-3549
Mailing Address - Country:US
Mailing Address - Phone:570-822-5191
Mailing Address - Fax:570-822-2450
Practice Address - Street 1:166 HANOVER ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-3549
Practice Address - Country:US
Practice Address - Phone:570-822-5191
Practice Address - Fax:570-822-2450
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD007591-E207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA18840Medicare ID - Type Unspecified
B33218Medicare UPIN