Basic Information
| Provider Information | |||||||||
| NPI: | 1457847162 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DR ROBERT YANOSHAK PALLIATIVE SPECIALIST LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 114 JASON DR | ||||||||
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| City: | PLAINS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 187022723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708266882 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 E MOUNTAIN BLVD | ||||||||
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| City: | WILKES BARRE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708087399 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2018 | ||||||||
| LastUpdateDate: | 07/23/2018 | ||||||||
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| AuthorizedOfficialLastName: | YANOSHAK | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 5708266882 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QH0002X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine |
No ID Information.