Provider Demographics
NPI:1285178079
Name:VRABLIC, HUGH MARTIN (MDIV)
Entity type:Individual
Prefix:
First Name:HUGH
Middle Name:MARTIN
Last Name:VRABLIC
Suffix:
Gender:M
Credentials:MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 WEST BERTSCH ST
Mailing Address - Street 2:
Mailing Address - City:LANSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18232
Mailing Address - Country:US
Mailing Address - Phone:570-249-7087
Mailing Address - Fax:
Practice Address - Street 1:34 W BERTSCH ST
Practice Address - Street 2:
Practice Address - City:LANSFORD
Practice Address - State:PA
Practice Address - Zip Code:18232-1905
Practice Address - Country:US
Practice Address - Phone:570-249-7087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
PAYM000329L227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered