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General NPI Number Information
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NPI Number | 1336159508
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Entity Type | Individual
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Provider Name | ALBERT DAVID JANERICH M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 901 WYOMING AVE
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City | WEST PITTSTON
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State | PA
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Zip | 18643-2742
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Country | US
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Telephone | 570-824-4111
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Fax | 570-824-3167
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Provider Business Mailing Address
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Address Line | 901 WYOMING AVE
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City | WEST PITTSTON
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State | PA
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Zip | 18643-2742
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Country | US
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Telephone | 570-824-4111
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Fax | 570-824-3167
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD021055E
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License Number State | PA
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