Joseph P. Chollak, Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD-011393-E Issued in PA

Legal business name

JOSEPH P. CHOLLAK, JR., M.D.

Practice address

950 Wyoming Ave
Forty Fort, PA 18704-3966

Phone

(570) 287-7704

NPI assigned

Jul 24, 2007

Organization subpart

No

Name

Mrs. Shelly Maransky

Title

Admin Assistant

Phone

(570) 287-7707

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph P Chollak Jr., MD

  • Family Medicine Physician
  • Kingston, PA
  • NPI 1932176435

  Family Medicine

  NPD (past)
• Polly Ann Schaefer, PA-C

  • Physician Assistant
  • Kingston, PA
  • NPI 1528110574
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 27, 2007.

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1407056732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 WYOMING AVE",
            "city": "FORTY FORT",
            "state": "PA",
            "postal_code": "187043966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 WYOMING AVE",
            "city": "FORTY FORT",
            "state": "PA",
            "postal_code": "187043966",
            "telephone_number": "570-287-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH P. CHOLLAK, JR., M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "MARANSKY",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "ADMIN ASSISTANT",
        "authorized_official_telephone_number": "570-287-7707",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD-011393-E",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "MD-011393-E",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA-003120-L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008576980004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Fremont PHD
• John Della Rosa, MD
• John P Brady MD PC
• Christine Jones
• Melissa Jones
• Anna Domnica Kadysewski
• Erin Kain
• Karen Cooper MD
• Alexandra Kester, M.S, CF-SLP
• Kameitri Leahn Knight

• All providers in Forty Fort, PA
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.