Provider Demographics
NPI:1558532820
Name:BIRCHOK, JONATHAN EUGENE (ATC)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:EUGENE
Last Name:BIRCHOK
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MEADOWCREST DR
Mailing Address - Street 2:
Mailing Address - City:CECIL
Mailing Address - State:PA
Mailing Address - Zip Code:15321-1155
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 WOOD ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-1912
Practice Address - Country:US
Practice Address - Phone:412-392-3816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0042032255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer