Provider Demographics
NPI:1477730299
Name:CEBULSKIE, WILLIAM P (R-AC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:P
Last Name:CEBULSKIE
Suffix:
Gender:M
Credentials:R-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 HILL ST
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15851-1304
Mailing Address - Country:US
Mailing Address - Phone:814-653-8701
Mailing Address - Fax:814-653-7853
Practice Address - Street 1:101 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1894
Practice Address - Country:US
Practice Address - Phone:814-653-8701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000530L171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1839376OtherHIGHMARK BLUE SHIELD
PA1869696OtherHIGHMARK BLUE SHIELD