Individual
GEORGE ANTHONY PTAKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
PO BOX 147, POCONO LAKE, PA 18347-0147
(570) 646-6905
(570) 646-6009
Mailing address
1109 AUDUBON DRIVE, CLARKS SUMMIT, PA 18411
(570) 576-4210
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD040378-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01158190
—
PA
Enumeration date
08/30/2006
Last updated
01/08/2019
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