Provider Demographics
NPI:1598798399
Name:VISCUSI, DONALD JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:JOSEPH
Last Name:VISCUSI
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 1:3010 W LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-3849
Mailing Address - Country:US
Mailing Address - Phone:814-833-2385
Mailing Address - Fax:814-833-5522
Practice Address - Street 1:3010 W LAKE RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-3849
Practice Address - Country:US
Practice Address - Phone:814-833-2385
Practice Address - Fax:814-833-5522
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033929E207Q00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00224275OtherRAILROAD MEDICARE
B41773Medicare UPIN
434901Medicare ID - Type Unspecified