Individual
JOSEPH M PRUSAKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
90 HOSPITAL RD, SUITE 200, BROOKVILLE, PA 15825-1382
(814) 849-1874
(814) 849-1444
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 849-1874
(814) 849-1444
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS003498L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007277640001
—
PA
Enumeration date
08/30/2006
Last updated
12/08/2016
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