Russell Droziak, M.D.

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

MD027632 Issued in PA

Legal business name

RUSSELL DROZIAK, M.D.

Doing business as

Clymer Family Medicine

Practice address

349 Franklin St
Clymer, PA 15728-1173

Phone

(724) 254-4314

NPI assigned

Jan 30, 2009

Last updated

Oct 23, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenny Heine

Title

Director of Operations

Phone

(858) 625-2990

Specialties & licenses 1

Addresses

Other names 1

• Clymer Family Medicine Doing business as

Tax ID family

Clymer Family Medicine2 organizations share this tax ID, including this one

Part of

Medvantx Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Russell Drozdiak

  • Family Medicine Physician
  • Clymer, PA
  • NPI 1639311384
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Russell Drozdiak, M.D.

  • Family Medicine Physician
  • Clymer, PA
  • NPI 1144294588
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1881832749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 FRANKLIN ST",
            "city": "CLYMER",
            "state": "PA",
            "postal_code": "157281173",
            "telephone_number": "724-254-4314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL DROZIAK, M.D.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2009-01-30",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "MD027632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clymer Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Rose Moore, PA-C
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• Russell Drozdiak
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• Amanda J Vaglia, D.O.

• Non-Pharmacy Dispensing Site in Clymer, PA
• Providers in Clymer, PA by specialty
• Non-Pharmacy Dispensing Site in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; 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.