Provider Demographics
NPI:1972607455
Name:PIASECKI, JOSEPH (D C)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:PIASECKI
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 259
Mailing Address - Street 2:
Mailing Address - City:EIGHTY FOUR
Mailing Address - State:PA
Mailing Address - Zip Code:15330-0259
Mailing Address - Country:US
Mailing Address - Phone:724-470-9600
Mailing Address - Fax:
Practice Address - Street 1:845 ROUTE 519 STE 3
Practice Address - Street 2:
Practice Address - City:EIGHTY FOUR
Practice Address - State:PA
Practice Address - Zip Code:15330-2163
Practice Address - Country:US
Practice Address - Phone:724-470-9600
Practice Address - Fax:724-470-9569
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009454111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020122190002Medicaid
PA412022OtherUPMC
PA6000008365OtherDEVICE (DME) REGISTRATION
PA11832765OtherCAQH
PA1782698OtherBLUE CROSS