Provider Demographics
NPI:1659691830
Name:WINIESKY, JAY (PAC)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:
Last Name:WINIESKY
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:251 7TH ST
Mailing Address - Street 2:SUITE 201B
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-6534
Mailing Address - Country:US
Mailing Address - Phone:724-335-6662
Mailing Address - Fax:724-335-3010
Practice Address - Street 1:251 7TH ST
Practice Address - Street 2:SUITE 201B
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6534
Practice Address - Country:US
Practice Address - Phone:724-335-6662
Practice Address - Fax:724-335-3010
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA000518363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical