Provider Demographics
NPI:1194996769
Name:HEALY, JOHN BERNARD (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BERNARD
Last Name:HEALY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 MAHONING ST
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-1246
Mailing Address - Country:US
Mailing Address - Phone:610-377-6881
Mailing Address - Fax:
Practice Address - Street 1:800 MAHONING ST
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-1246
Practice Address - Country:US
Practice Address - Phone:610-377-6881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA046146 L2085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology