Provider Demographics
NPI:1982788451
Name:SURKOSKY, STUART JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:JOSEPH
Last Name:SURKOSKY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:837 EVANS CITY RD
Mailing Address - Street 2:#202
Mailing Address - City:RENFREW
Mailing Address - State:PA
Mailing Address - Zip Code:16053
Mailing Address - Country:US
Mailing Address - Phone:724-789-9797
Mailing Address - Fax:724-789-9910
Practice Address - Street 1:837 EVANS CITY RD
Practice Address - Street 2:#202
Practice Address - City:RENFREW
Practice Address - State:PA
Practice Address - Zip Code:16053
Practice Address - Country:US
Practice Address - Phone:724-789-9797
Practice Address - Fax:724-789-9910
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005245111N00000X
PAAJ005245111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA448263OtherHEALTH AMERICA
PA480366RMFMedicare ID - Type UnspecifiedINDIVIDUAL PROVIDER NUMBE
PA448263OtherHEALTH AMERICA