Provider Demographics
NPI:1417074188
Name:PIERKO, DARIUSZ R (DO)
Entity Type:Individual
Prefix:
First Name:DARIUSZ
Middle Name:R
Last Name:PIERKO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 FRANKLIN STREET
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-410-8300
Mailing Address - Fax:814-410-8331
Practice Address - Street 1:339 WEST UNION STREET
Practice Address - Street 2:
Practice Address - City:SUMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-1543
Practice Address - Country:US
Practice Address - Phone:814-444-8300
Practice Address - Fax:814-443-3959
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015063207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025202180002Medicaid
PA1025202180002Medicaid