Provider Demographics
NPI:1699470302
Name:WARUNEK, EDWARD (PT)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:WARUNEK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18640-1949
Mailing Address - Country:US
Mailing Address - Phone:570-208-2787
Mailing Address - Fax:570-208-2788
Practice Address - Street 1:33 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18640-1949
Practice Address - Country:US
Practice Address - Phone:570-208-2787
Practice Address - Fax:570-208-2788
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT031064225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist