Provider Demographics
NPI:1548248396
Name:BRISKIE, JOSEPH JR (DO)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:BRISKIE
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:667 N RIVER STREET STE 201
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18705-1013
Mailing Address - Country:US
Mailing Address - Phone:570-824-9847
Mailing Address - Fax:570-824-9044
Practice Address - Street 1:142 MUNDY ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-6875
Practice Address - Country:US
Practice Address - Phone:570-825-7700
Practice Address - Fax:570-825-5505
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009449L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016463100011Medicaid
PA0016463100011Medicaid
PA903970RAAMedicare PIN
PAG48115Medicare UPIN