Healthcare Provider Details

I. General information

NPI: 1780681601
Provider Name (Legal Business Name): PETER T. YASWINSKI JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

369 E BROWN ST
EAST STROUDSBURG PA
18301-9101
US

IV. Provider business mailing address

179 INDEPENDENCE RD
EAST STROUDSBURG PA
18301-9207
US

V. Phone/Fax

Practice location:
  • Phone: 570-421-6040
  • Fax: 570-421-5290
Mailing address:
  • Phone: 570-426-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD028986E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: