Active NPI
Chet Muklewicz, EDD
- Psychologist
- Scranton, PA
National Provider Identifier
1609924711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 008482-L
- Practice address
- 1030 Marion St
Scranton, PA 18509-2316 - Phone
- (570) 961-0600
- Fax
- (570) 961-0600
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 008482-L | PA | Primary |
Addresses
Primary practice location
1030 Marion St
Scranton, PA 18509-2316
Mailing address
1527 Adams Ave
Dunmore, PA 18509-2437
Phone (570) 344-1669
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008482-L | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609924711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1527 ADAMS AVE",
"city": "DUNMORE",
"state": "PA",
"postal_code": "185092437",
"telephone_number": "570-344-1669",
"fax_number": "570-344-8684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 MARION ST",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185092316",
"telephone_number": "570-961-0600",
"fax_number": "570-961-0600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUKLEWICZ",
"first_name": "CHET",
"name_prefix": "Dr.",
"credential": "EDD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "008482-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.