Provider Demographics
NPI:1194795468
Name:GORSKI, STANLEY J (DO)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:J
Last Name:GORSKI
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:8 OAK GROVE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PINE GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17963-1226
Mailing Address - Country:US
Mailing Address - Phone:570-345-3321
Mailing Address - Fax:570-345-6470
Practice Address - Street 1:8 OAK GROVE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:PINE GROVE
Practice Address - State:PA
Practice Address - Zip Code:17963-1226
Practice Address - Country:US
Practice Address - Phone:570-345-3321
Practice Address - Fax:570-345-6470
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2011-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS011066L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001852829Medicaid
PAH46393Medicare UPIN
PA001852829Medicaid