Individual
DR. KENNETH R. USTYNOSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, FACS
Contact information
Practice address
110 ONDISH RD, SHAVERTOWN, PA 18708-9415
(570) 696-4566
Mailing address
110 ONDISH RD, SHAVERTOWN, PA 18708-9415
(570) 696-4566
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD032192E
PA
Other
Enumeration date
05/20/2012
Last updated
05/20/2012
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