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Organization

JOSEPH P. CHOLLAK, JR., M.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SHELLY MARANSKY (ADMIN ASSISTANT)
(570) 287-7707
Entity
Organization

Contact information

Practice address
950 WYOMING AVE, FORTY FORT, PA 18704-3966
(570) 287-7704
Mailing address
950 WYOMING AVE, FORTY FORT, PA 18704-3966

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD-011393-E
PA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
MD-011393-E
PA
363A00000X
Physician Assistant
MA-003120-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0008576980004
PA
Enumeration date
07/24/2007
Last updated
11/27/2007
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