Provider Demographics
NPI:1679826036
Name:TERNOSKY, ADAM ROBERT (PA-C)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:ROBERT
Last Name:TERNOSKY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1253 RAYMOND AVENUE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018
Mailing Address - Country:US
Mailing Address - Phone:610-428-7093
Mailing Address - Fax:
Practice Address - Street 1:1101 SOUTH CEDAR CREST BLVD.
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-7902
Practice Address - Country:US
Practice Address - Phone:610-435-3111
Practice Address - Fax:610-432-5953
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOA002938363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant