Provider Demographics
NPI:1306468475
Name:SMARACHECK, ALEX
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:SMARACHECK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6521 ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:DELMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15626-2402
Mailing Address - Country:US
Mailing Address - Phone:724-468-8764
Mailing Address - Fax:724-468-8785
Practice Address - Street 1:6521 ROUTE 22
Practice Address - Street 2:
Practice Address - City:DELMONT
Practice Address - State:PA
Practice Address - Zip Code:15626-2402
Practice Address - Country:US
Practice Address - Phone:724-468-8764
Practice Address - Fax:724-468-8785
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS023679207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty