Provider Demographics
NPI:1417023193
Name:DRS C AND D CZARNECKI PA
Entity Type:Organization
Organization Name:DRS C AND D CZARNECKI PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CASIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:CZARNECKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-676-2242
Mailing Address - Street 1:9412 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114
Mailing Address - Country:US
Mailing Address - Phone:215-676-2242
Mailing Address - Fax:215-676-4938
Practice Address - Street 1:9412 ACADEMY RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114
Practice Address - Country:US
Practice Address - Phone:215-676-2242
Practice Address - Fax:215-676-4938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0801530001Medicare NSC