Provider Demographics
NPI:1841531985
Name:KASENCHAK, JAMES ERIC (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ERIC
Last Name:KASENCHAK
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 1:255 ROUTE 220 HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:MUNCY
Mailing Address - State:PA
Mailing Address - Zip Code:17756-7569
Mailing Address - Country:US
Mailing Address - Phone:570-321-0880
Mailing Address - Fax:570-321-8012
Practice Address - Street 1:255 ROUTE 220 HWY STE 203
Practice Address - Street 2:
Practice Address - City:MUNCY
Practice Address - State:PA
Practice Address - Zip Code:17756-7569
Practice Address - Country:US
Practice Address - Phone:570-321-0880
Practice Address - Fax:570-321-8012
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV27580207W00000X
PAMD462419207W00000X, 207WX0107X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program