Provider Demographics
NPI:1538515622
Name:STEPHEN A POKOWICZ, DC
Entity Type:Organization
Organization Name:STEPHEN A POKOWICZ, DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:POKOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-689-5757
Mailing Address - Street 1:543 EASTON TPKE
Mailing Address - Street 2:STE 102
Mailing Address - City:LAKE ARIEL
Mailing Address - State:PA
Mailing Address - Zip Code:18436-4798
Mailing Address - Country:US
Mailing Address - Phone:570-689-5757
Mailing Address - Fax:570-689-5758
Practice Address - Street 1:543 EASTON TPKE
Practice Address - Street 2:STE 102
Practice Address - City:LAKE ARIEL
Practice Address - State:PA
Practice Address - Zip Code:18436-4798
Practice Address - Country:US
Practice Address - Phone:570-689-5757
Practice Address - Fax:570-689-5758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC5669L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA411901Medicare UPIN