Individual
NIKOLAS GRIFFIN GUSHKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1000 E MOUNTAIN DR, WILKES BARRE, PA 18711-0027
(570) 808-7300
Mailing address
408 UNION ST, EXETER, PA 18643-1079
(570) 592-4138
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA062026
PA
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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