Provider Demographics
NPI:1831164136
Name:THORYK, DAVID T (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:T
Last Name:THORYK
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 1:162 CHESTERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:PA
Mailing Address - Zip Code:17078-8745
Mailing Address - Country:US
Mailing Address - Phone:717-350-2588
Mailing Address - Fax:
Practice Address - Street 1:162 CHESTERFIELD DR
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:PA
Practice Address - Zip Code:17078-8745
Practice Address - Country:US
Practice Address - Phone:717-350-2588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2024-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD056971L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA610307Medicare ID - Type Unspecified
PAF98129Medicare UPIN