Provider Demographics
NPI:1598937682
Name:GARCZEWSKI, LARRY RUSSELL SR
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:RUSSELL
Last Name:GARCZEWSKI
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-5040
Mailing Address - Country:US
Mailing Address - Phone:724-654-2147
Mailing Address - Fax:724-654-2147
Practice Address - Street 1:1711 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-5040
Practice Address - Country:US
Practice Address - Phone:724-654-2147
Practice Address - Fax:724-654-2147
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications