Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MD070701L | PA |
NPI | 1003872284 |
---|---|
Provider Name | Dr. Gerald J Negvesky |
First Address | East Stroudsburg, PA 18301-8260 |
Second Address | East Stroudsburg, PA 18301-8260 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 07/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0018055060004 | (05) | PA |
H18144 | (02) |