| Organization Name: | MARK A GONSKY DO |
| NPI Number: | 1740428689 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK GONSKY (PHYSICAN) |
| Mailing Address: | 111 S Mountain Blvd Mountain Top |
| State: | PA US |
| Postal Code: | 187071921 |
| Phone Number: | 5704035000 |
| Fax Number: | 5706936178 |
| NPI Enumeration Date: | 01/30/2009 |
| NPI Last Update Date: | 01/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | OSOO51O5L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |