| Wisniewski Medical Llc | |
|
340 1st St Conemaugh PA 15909-1906 | |
| (814) 535-7721 | |
| (814) 535-2105 |
| Full Name | Wisniewski Medical Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 340 1st St, Conemaugh, Pennsylvania |
| Authorized Official Name and Position | John Wisniewski (OWN) |
| Authorized Official Contact | 8145357721 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisniewski Medical Llc 340 1st St Conemaugh PA 15909-1906 Ph: (814) 535-7721 | Wisniewski Medical Llc 340 1st St Conemaugh PA 15909-1906 Ph: (814) 535-7721 |
| NPI Number | 1376385948 |
|---|---|
| Provider Enumeration Date | 06/12/2024 |
| Last Update Date | 06/28/2024 |
| Medicare PECOS PAC ID | 1759828213 |
|---|---|
| Medicare Enrollment ID | O20240801001600 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376385948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | John M Wisniewski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154472579 PECOS PAC ID: 9830220870 Enrollment ID: I20100708000320 |
| Provider Name | Kimberly Wisniewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003993007 PECOS PAC ID: 8224317136 Enrollment ID: I20161117000557 |