Provider Demographics
NPI:1669445755
Name:PINSKY, ALEXANDER J (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:J
Last Name:PINSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 PARK ST
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-1445
Mailing Address - Country:US
Mailing Address - Phone:570-251-6641
Mailing Address - Fax:570-253-8228
Practice Address - Street 1:141 SALEM AVE STE 302
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:PA
Practice Address - Zip Code:18407-2500
Practice Address - Country:US
Practice Address - Phone:570-282-2031
Practice Address - Fax:570-282-2534
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417682208000000X
NY208766-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018711090007Medicaid
PAH19709Medicare UPIN
PA054554JJMMedicare Oscar/Certification
NY01990578Medicaid
PA054554Medicare ID - Type Unspecified
PA0018711090007Medicaid
PA054554JJMMedicare Oscar/Certification
PA370020699OtherRR MEDICARE PIN
H19709Medicare UPIN