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Organization

RICHARD S KOLECKI MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PETER MARYCZ JR. REP (REP)
(570) 450-6206
Entity
Organization

Contact information

Practice address
701 OSTRUM ST, SUITE 401, FOUNTAIN HILL, PA 18015-1155
(610) 317-9968
(610) 317-9800
Mailing address
PO BOX 517, HAZLETON, PA 18201-0517
(570) 450-6200
(570) 450-6207

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD042682L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0014641940005
PA
Enumeration date
10/24/2006
Last updated
06/11/2008
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