Provider Demographics
NPI:1437276128
Name:TARAPCHAK, STEPHANIE (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:TARAPCHAK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1239 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17921-1207
Mailing Address - Country:US
Mailing Address - Phone:570-875-3508
Mailing Address - Fax:570-875-3563
Practice Address - Street 1:1239 CENTRE ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:PA
Practice Address - Zip Code:17921-1207
Practice Address - Country:US
Practice Address - Phone:570-875-3508
Practice Address - Fax:570-875-3563
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009444L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017921680006Medicaid
PAH11842Medicare UPIN
PA0017921680006Medicaid