Provider Demographics
NPI:1942468210
Name:ZAWISZA, JOSEPH (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:ZAWISZA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 S GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SCHUYLKILL HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17972-1107
Mailing Address - Country:US
Mailing Address - Phone:570-385-3826
Mailing Address - Fax:570-385-4125
Practice Address - Street 1:523 S GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:SCHUYLKILL HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17972-1107
Practice Address - Country:US
Practice Address - Phone:570-385-3826
Practice Address - Fax:570-385-4125
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT 011110207R00000X, 208000000X
PAOS014351208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics