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Organization
RICHARD CHWASTIAK
Active
Organization
RICHARD CHWASTIAK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD CHWASTIAK DPM (OWNER)
(570) 668-5170
Entity
Organization
Contact information
Practice address
617 E BROAD ST, TAMAQUA, PA 18252-2206
(570) 668-5170
(570) 668-5171
Mailing address
617 E BROAD ST, TAMAQUA, PA 18252-2206
(570) 668-5170
(570) 668-5171
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02609400
CAPITAL BLUE CROSS
PA
01
—
1338692
HIGHMARK BS
—
01
—
480000509
TRAVELERS MEDICARE
PA
Enumeration date
01/31/2006
Last updated
03/16/2015
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