Provider Demographics
NPI:1376711374
Name:BINKOWSKI, JOHN V (MA SP)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:V
Last Name:BINKOWSKI
Suffix:
Gender:M
Credentials:MA SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 STROBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:INWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:25428-3175
Mailing Address - Country:US
Mailing Address - Phone:304-229-8216
Mailing Address - Fax:
Practice Address - Street 1:BERKELEY BOARD OF EDUCATION
Practice Address - Street 2:401
Practice Address - City:SOUTH QUEEN STREET
Practice Address - State:WV
Practice Address - Zip Code:25401
Practice Address - Country:US
Practice Address - Phone:304-267-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV0429235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0154895000Medicaid