Provider Demographics
NPI:1962473959
Name:PREATE, DONALD L JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:L
Last Name:PREATE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:300 LACKAWANNA AVE STE 200
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-2001
Practice Address - Country:US
Practice Address - Phone:570-342-7864
Practice Address - Fax:570-588-3588
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2021-12-30
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Provider Licenses
StateLicense IDTaxonomies
PAMD-064030-L208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017867140001Medicaid
PAH15008Medicare UPIN
PA0017867140001Medicaid