Provider Demographics
NPI:1528095825
Name:OFCHARSKY, EVA
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:OFCHARSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-5430
Mailing Address - Country:US
Mailing Address - Phone:570-288-6688
Mailing Address - Fax:570-714-1300
Practice Address - Street 1:355 MARKET ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5430
Practice Address - Country:US
Practice Address - Phone:570-288-6688
Practice Address - Fax:570-714-1300
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA814243OtherFIRST PRIORITY HMO
PA00177997680001Medicaid
PA243975OtherHIGHMARK BLUESHIELD
PA814243OtherFIRST PRIORITY HMO