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NPI Code Detail

MEDICARE: DR. JOHN JOSEPH SIROTNAK JR. MD

MEDICARE: DR. JOHN JOSEPH SIROTNAK JR. MD
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
1207Y00000XOtolaryngology PhysicianMD027448LPA

Other Identifiers

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

General Provider Information

NPI Number : 1417929498
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN JOSEPH SIROTNAK JR. MD
Provider Business Mailing Address
First Line : 434 DUNMORE ST
Second Line :
City : THROOP
State : PA
Zip : 18512-1147
Country : US
Telephone Number : 570-489-4722
Fax Number : 570-489-4725
Provider Business Practice Location Address
First Line : 434 DUNMORE ST
Second Line :
City : THROOP
State : PA
Zip : 18512-1147
Country : US
Telephone Number : 570-489-4722
Fax Number : 570-489-4725
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 07/08/2007

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