Provider Demographics
NPI:1881689214
Name:USCINSKI, RAYMOND JOSEPH (DPM)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:JOSEPH
Last Name:USCINSKI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-2222
Mailing Address - Country:US
Mailing Address - Phone:814-368-8955
Mailing Address - Fax:814-362-6303
Practice Address - Street 1:35 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-2222
Practice Address - Country:US
Practice Address - Phone:814-368-8955
Practice Address - Fax:814-362-6303
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001589L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005026840001Medicaid
PA0005026840001Medicaid
167183Medicare ID - Type Unspecified
5334820001Medicare NSC