Active NPI
Jodi Lyn Cieszkowski, REGISTERED NURSE
- Internal Medicine Physician
- Scranton, PA
National Provider Identifier
1891565016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- OS012156
- Practice address
- 409 N Main Ave Ste 1
Scranton, PA 18504-1798 - Phone
- (570) 209-7878
- Fax
- (570) 209-7715
- NPI assigned
- Jan 8, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | OS012156 | PA | Primary |
Addresses
Primary practice location
409 N Main Ave Ste 1
Scranton, PA 18504-1798
Mailing address
18 Sonny Dr
Old Forge, PA 18518-1137
Phone (570) 468-5406
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 |
|---|---|---|---|
| OS012156 | PA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704672000000",
"number": "1891565016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 SONNY DR",
"city": "OLD FORGE",
"state": "PA",
"postal_code": "185181137",
"telephone_number": "570-468-5406",
"fax_number": "570-209-7715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 N MAIN AVE STE 1",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185041798",
"telephone_number": "570-209-7878",
"fax_number": "570-209-7715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIESZKOWSKI",
"first_name": "JODI",
"middle_name": "LYN",
"credential": "REGISTERED NURSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-08",
"last_updated": "2024-01-08",
"certification_date": "2024-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "OS012156",
"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 Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.