Individual
GREGORY A FORMANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
205 E BROWN ST, 2ND FLOOR, EAST STROUDSBURG, PA 18301-3006
(570) 420-2188
(570) 421-3493
Mailing address
PO BOX 827658, PHILADELPHIA, PA 19182-7658
(570) 420-4951
(570) 476-3754
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
0101232517
VA
207RH0003X
Hematology & Oncology Physician
Primary
MD041860L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
GROUP PTAN
VA
Enumeration date
06/17/2006
Last updated
07/22/2013
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