Provider Demographics
NPI:1538160205
Name:NAWROCKI, JOSEPH S (DMD, MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:S
Last Name:NAWROCKI
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 E MAIDEN ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4912
Mailing Address - Country:US
Mailing Address - Phone:724-225-3022
Mailing Address - Fax:724-225-6386
Practice Address - Street 1:90 E MAIDEN ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4912
Practice Address - Country:US
Practice Address - Phone:724-225-3022
Practice Address - Fax:724-225-6386
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047712L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF57352Medicare UPIN