MEDICARE: VADIM LOSHAKOV I 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	207V00000X	Obstetrics & Gynecology Physician	MD419480	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003815721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VADIM LOSHAKOV I M.D.

Provider Business Mailing Address
First Line	:	PO BOX 783311
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19178-3311
Country	:	US
Telephone Number	:	484-884-4500
Fax Number	:	484-884-0699

Provider Business Practice Location Address
First Line	:	1000 ALLIANCE DR
Second Line	:
City	:	HAZLETON
State	:	PA
Zip	:	18202-3234
Country	:	US
Telephone Number	:	570-501-6450
Fax Number	:	570-501-6436

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	02/13/2020

Similar Medicare Providers

1396711974 — PATRICK FIERO MD
Practice Location Address:

1000 ALLIANCE DR
HAZLETON, PA
18202-3234

Practice Phone: 570-501-6450
Practice Fax: 570-501-6436

1982662524 — DR. SCOTT DOUGLAS MUIR DO
Practice Location Address:

1000 ALLIANCE DR , SUITE 10
HAZLETON, PA
18202-3234

Practice Phone: 570-501-6450
Practice Fax: 570-501-6436

1851348478 — GREATER HAZLETON RADIOLOGY ASSOCIATES
Practice Location Address:

1000 ALLIANCE DR , 110
HAZLETON, PA
18202-3234

Practice Phone: 570-459-4674
Practice Fax:

1245260850 — MS. THERESA MARY BASESKI D.O.
Practice Location Address:

1000 ALLIANCE DR STE 10
HAZLETON, PA
18202-3234

Practice Phone: 570-501-6450
Practice Fax: 570-501-6436

1225254386 — DR. DEBORAH ANNE GORSKI MD
Practice Location Address:

1000 ALLIANCE DR
HAZLETON, PA
18202-3234

Practice Phone: 570-474-5048
Practice Fax:

1124226907 — DR. JODI WASHINSKY LENKO MD
Practice Location Address:

1000 ALLIANCE DR
HAZLETON, PA
18202-3234

Practice Phone: 570-459-2226
Practice Fax: 570-459-2511

Directions to “ VADIM LOSHAKOV I M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.