Formanek, Gregory A

Formanek, Gregory A is an individual health care provider with primary practice located at 205 E Brown St 2Nd Floor, East Stroudsburg PA 18301-3006. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Formanek, Gregory A can be contacted via phone (570) 420-2188.

Contact Information

Primary practice address
205 E Brown St 2Nd Floor East Stroudsburg PA 18301-3006
Phone: (570) 420-2188
Fax: (570) 421-3493
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 0101232517 Virginia
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X MD041860L Pennsylvania

Profile Details

NPI number 1568407583
LBN Legal business name Formanek, Gregory A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2006
Last updated Jul 22nd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568407583 NPPES
Virginia Other C06778 GROUP PTAN

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