Provider Demographics
NPI:1790742690
Name:HNELESKI, IGNATIUS S III (MD)
Entity Type:Individual
Prefix:DR
First Name:IGNATIUS
Middle Name:S
Last Name:HNELESKI
Suffix:III
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 1:845 W CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-4878
Mailing Address - Country:US
Mailing Address - Phone:610-692-8100
Mailing Address - Fax:610-436-4011
Practice Address - Street 1:845 W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-4878
Practice Address - Country:US
Practice Address - Phone:610-692-8100
Practice Address - Fax:610-436-4011
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD054932L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017062400001Medicaid
PA8970900EHDMedicare ID - Type Unspecified
PA0017062400001Medicaid
PA0348970001Medicare NSC
PACB5737Medicare PIN