Provider Demographics
NPI:1689684037
Name:CZARNECKI, JOSEPH E (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:E
Last Name:CZARNECKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9410 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-2624
Mailing Address - Country:US
Mailing Address - Phone:215-934-7947
Mailing Address - Fax:215-934-5963
Practice Address - Street 1:8019 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-2736
Practice Address - Country:US
Practice Address - Phone:215-332-1300
Practice Address - Fax:215-332-5219
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PWOS0078L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA041675EBNMedicare ID - Type Unspecified
PAD66283Medicare UPIN