Provider Demographics
NPI:1871679548
Name:SPYCHALSKI, JOHN T (MED)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:T
Last Name:SPYCHALSKI
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
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Mailing Address - Street 1:PO BOX 597
Mailing Address - Street 2:SUITE 805
Mailing Address - City:MOUNTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17554-0597
Mailing Address - Country:US
Mailing Address - Phone:570-323-6944
Mailing Address - Fax:570-323-4529
Practice Address - Street 1:790 NEW HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2137
Practice Address - Country:US
Practice Address - Phone:717-390-0353
Practice Address - Fax:717-390-1812
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2016-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAPS003849L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical