Individual
EDWARD RICHARD PROSTKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
380 W CHESTNUT ST STE 101, WASHINGTON, PA 15301-4658
(724) 228-1414
(724) 228-8579
Mailing address
380 W CHESTNUT ST STE 101, WASHINGTON, PA 15301-4658
(724) 228-1414
(724) 228-8579
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD024694E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000888021
—
PA
01
—
10934442
CAQH
—
Enumeration date
09/12/2005
Last updated
10/01/2020
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