Provider Demographics
NPI:1982958898
Name:NORTHEAST HYPERBARIC, INC.
Entity Type:Organization
Organization Name:NORTHEAST HYPERBARIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:STARISNKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-881-4025
Mailing Address - Street 1:PO BOX 241
Mailing Address - Street 2:
Mailing Address - City:DELAWARE WATER GAP
Mailing Address - State:PA
Mailing Address - Zip Code:18327-0241
Mailing Address - Country:US
Mailing Address - Phone:610-881-4025
Mailing Address - Fax:610-881-4066
Practice Address - Street 1:215 S ROBINSON AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:PEN ARGYL
Practice Address - State:PA
Practice Address - Zip Code:18072-1946
Practice Address - Country:US
Practice Address - Phone:610-881-4025
Practice Address - Fax:610-881-4066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002906L2083P0011X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty