Individual
ANNA M. LAYCHOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
420 SOUTH JACKSON STREET, POTTSVILLE, PA 17901-3625
(570) 621-5325
(570) 621-5806
Mailing address
450 WASHINGTON STREET, BOX 9, POTTSVILLE, PA 17901-3655
(570) 621-5018
(570) 621-5806
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD035031E
PA
2085R0202X
Diagnostic Radiology Physician
Primary
MD035031E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001129976
—
PA
05
—
0011299760005
—
PA
Enumeration date
09/20/2005
Last updated
11/06/2018
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