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NPI Code Detail

MEDICARE: IWONA JOANNA JANICKA MD

MEDICARE: IWONA JOANNA JANICKA 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
1207QH0002XHospice and Palliative Medicine (Family Medicine) PhysicianMD064990LPA
2208M00000XHospitalist PhysicianMD064990LPA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00683486OTHERPARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
150074295OTHERPACAPITAL BLUECROSS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4P002561OTHERPAGATEWAY
531822OTHERPAHIGHMARK BLUE SHIELD
6MD064990LOTHERPALICENSE
7PEARLOTHERPAHEALTH AMERICA

General Provider Information

NPI Number : 1902803257
Entity Type Code : Individual
Provider Name (Legal Business Name) : IWONA JOANNA JANICKA MD
Provider Business Mailing Address
First Line : 601 MEMORY LN
Second Line :
City : YORK
State : PA
Zip : 17402-2231
Country : US
Telephone Number : 717-851-1405
Fax Number :
Provider Business Practice Location Address
First Line : 112 N 7TH ST
Second Line :
City : CHAMBERSBURG
State : PA
Zip : 17201-1720
Country : US
Telephone Number : 717-217-4300
Fax Number : 717-217-4217
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2005
Last Update Date : 09/12/2024

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Directions to “ IWONA JOANNA JANICKA MD” Practice Location

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