Doctor Name: | JOSEPH CHESLICK |
NPI Number: | 1104286095 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CRNP |
License Number: | SP014965 |
Business Practice Address: | 100 Route 6 Waymart, PA - 18472 |
Business Phone Number: | 5706903900 |
Business Fax Number: | |
Mailing Address: | 57 Scott St, SWOYERSVILLE |
State: | PA |
Postal Code: | 187042932 |
Phone Number: | 5706903900 |
Fax Number: | |
NPI Enumeration Date: | 03/04/2016 |
NPI Last Update Date: | 03/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | SP014965 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |