Provider Demographics
NPI:1881191146
Name:FERENCHAK, GREGORY JOHN (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:JOHN
Last Name:FERENCHAK
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 1:2550 MOSSIDE BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3514
Mailing Address - Country:US
Mailing Address - Phone:412-457-1100
Mailing Address - Fax:412-457-0250
Practice Address - Street 1:2550 MOSSIDE BLVD STE 500
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3514
Practice Address - Country:US
Practice Address - Phone:412-457-1100
Practice Address - Fax:412-457-0250
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD473445207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine