Provider Demographics
NPI:1881740850
Name:KUSMIREK, JOANNA S (MD)
Entity type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:S
Last Name:KUSMIREK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 789967
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-9967
Mailing Address - Country:US
Mailing Address - Phone:484-622-7395
Mailing Address - Fax:484-622-7399
Practice Address - Street 1:612 FAYETTE ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1797
Practice Address - Country:US
Practice Address - Phone:610-828-8500
Practice Address - Fax:610-828-9736
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2018-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD432562207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine