Provider Demographics
NPI:1619758984
Name:JOSEPH RADZWILKA DO LLC
Entity Type:Organization
Organization Name:JOSEPH RADZWILKA DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:RADZWILKA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-760-6531
Mailing Address - Street 1:308 DONNAS WAY
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:PA
Mailing Address - Zip Code:18643-1243
Mailing Address - Country:US
Mailing Address - Phone:570-760-6531
Mailing Address - Fax:570-299-2272
Practice Address - Street 1:308 DONNAS WAY
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:PA
Practice Address - Zip Code:18643-1243
Practice Address - Country:US
Practice Address - Phone:570-760-6531
Practice Address - Fax:570-299-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care