Provider Demographics
NPI:1962965970
Name:JUSKIEWICZ, ALINA (PA)
Entity type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:JUSKIEWICZ
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 WOODBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-8501
Mailing Address - Country:US
Mailing Address - Phone:410-912-6330
Mailing Address - Fax:
Practice Address - Street 1:1630 WOODBROOKE DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-8501
Practice Address - Country:US
Practice Address - Phone:410-912-6330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-08
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601012798363AS0400X
NY025209363AS0400X
MDC08479363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical