Healthcare Provider Details

I. General information

NPI: 1659369841
Provider Name (Legal Business Name): JOHN RALPH HRATKO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 N MAIN ST
NAZARETH PA
18064-1444
US

IV. Provider business mailing address

207 N MAIN ST
NAZARETH PA
18064-1444
US

V. Phone/Fax

Practice location:
  • Phone: 610-746-2061
  • Fax: 610-365-8636
Mailing address:
  • Phone: 610-746-2061
  • Fax: 610-365-8636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number037569-E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: