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Organization

PRODIGY DIALYSIS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CORY YACYNYCH (PRACTICE MANAGER)
(814) 299-4676
Entity
Organization

Contact information

Practice address
211 THOMPSON ST, SEWARD, PA 15954-2053
(814) 539-0798
(814) 536-4751
Mailing address
88 OSBORNE ST, JOHNSTOWN, PA 15905-4146
(814) 539-0798
(814) 536-4751

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
MD042825E
PA

Other

Enumeration date
10/30/2012
Last updated
11/09/2012
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