| Miriam Shustik, Md, Pc | |
|
203 Park Vista Ter Allentown PA 18104-4525 | |
| (610) 703-7244 | |
| Not Available |
| Full Name | Miriam Shustik, Md, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 203 Park Vista Ter, Allentown, Pennsylvania |
| Authorized Official Name and Position | Miriam Shustik (OWNER) |
| Authorized Official Contact | 6107037244 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miriam Shustik, Md, Pc 203 Park Vista Ter Allentown PA 18104-4525 Ph: (610) 703-7244 | Miriam Shustik, Md, Pc 203 Park Vista Ter Allentown PA 18104-4525 Ph: (610) 703-7244 |
| NPI Number | 1649546946 |
|---|---|
| Provider Enumeration Date | 03/30/2012 |
| Last Update Date | 03/30/2012 |
| Medicare PECOS PAC ID | 9739344698 |
|---|---|
| Medicare Enrollment ID | O20120628000051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649546946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD062421L (Pennsylvania) | Primary |
| Provider Name | Miriam Shustik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427062736 PECOS PAC ID: 9739196056 Enrollment ID: I20060403000086 |
| Provider Name | Catherine T Caruso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518964907 PECOS PAC ID: 0143316034 Enrollment ID: I20071024000168 |
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