Provider Demographics
NPI:1285745117
Name:TRUSKOWSKI, JOSEPH R (CRNP)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:R
Last Name:TRUSKOWSKI
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 THIRD ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2301
Mailing Address - Country:US
Mailing Address - Phone:724-775-9150
Mailing Address - Fax:724-775-9153
Practice Address - Street 1:219 THIRD STREET
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2301
Practice Address - Country:US
Practice Address - Phone:724-775-9150
Practice Address - Fax:724-775-9153
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASPOO7O97363LP0808X
PASP007097363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP99427Medicare UPIN
PA073748Medicare ID - Type Unspecified