MEDICARE: PETER T. YASWINSKI JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	MD028986E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	065640	OTHER	PA	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780681601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER T. YASWINSKI JR. M.D.

Provider Business Mailing Address
First Line	:	179 INDEPENDENCE RD
Second Line	:
City	:	EAST STROUDSBURG
State	:	PA
Zip	:	18301-9207
Country	:	US
Telephone Number	:	570-426-2700
Fax Number	:

Provider Business Practice Location Address
First Line	:	369 E BROWN ST
Second Line	:
City	:	EAST STROUDSBURG
State	:	PA
Zip	:	18301-9101
Country	:	US
Telephone Number	:	570-421-6040
Fax Number	:	570-421-5290

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	01/21/2025

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