Provider Demographics
NPI:1699784488
Name:KORSZNIAK, JOSEPH CLAYTON (PAC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:CLAYTON
Last Name:KORSZNIAK
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 N 6TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-3668
Mailing Address - Country:US
Mailing Address - Phone:610-898-0766
Mailing Address - Fax:610-898-8275
Practice Address - Street 1:35 N 6TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3668
Practice Address - Country:US
Practice Address - Phone:610-898-0766
Practice Address - Fax:610-898-8275
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001528L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA055152QCHMedicare PIN