Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | OH000004 | PA |
N | 222Z00000X | Podiatrist | OH000004 | PA |
Y | 224P00000X | Prosthetist | PO000002 | PA |
NPI | 1336637040 |
---|---|
Provider Name | Mr. John G Patsko |
First Address | Cranberry Twp, PA 16066-3610 |
Second Address | Cranberry Twp, PA 16066-3610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2018 |
Last Update Date | 27/04/2018 |