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Individual
RICHARD T CETKOWSKI JR.
Active
Individual
RICHARD T CETKOWSKI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP009127
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102211740
—
PA
01
—
1568941
GATEWAY-WMG
PA
01
—
1926547
HIGHMARK BS FREEDOM BLUE
PA
01
—
212350
JOHNS HOPKINS
—
01
—
50073194
CAPITAL BLUE CROSS-YH
PA
Enumeration date
09/06/2006
Last updated
05/17/2016
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