Provider Demographics
NPI:1861811804
Name:DARLENE KAY NALESNIK PC
Entity type:Organization
Organization Name:DARLENE KAY NALESNIK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:NALESNIK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:570-226-1963
Mailing Address - Street 1:1258 PURDYTOWN TPKE
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18438-6793
Mailing Address - Country:US
Mailing Address - Phone:570-226-1963
Mailing Address - Fax:570-226-1967
Practice Address - Street 1:1258 PURDYTOWN TPKE
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:PA
Practice Address - Zip Code:18438-6793
Practice Address - Country:US
Practice Address - Phone:570-226-1963
Practice Address - Fax:570-226-1967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-07
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS0084331103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA901646Medicare PIN