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Nicholas Alan Superko
Student in an Organized Health Care Education/Training Program in Towanda, Pennsylvania
NPI 1164298543

Nicholas Alan Superko is a Student in an Organized Health Care Education/Training Program based in Laceyville, PA. Nicholas Alan Superko practices in Towanda, PA. The NPI Number for Nicholas Alan Superko is 1164298543 and holds a License No. PI124458 (Pennsylvania).

The current practice location address for Nicholas Alan Superko is 148 Ennis Ln, Towanda, PA and can be reached out via phone at 570-265-4769.

Location: 148 Ennis Ln, Towanda, PA, 18623-6637
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164298543
Provider Name
Nicholas Alan Superko
Credential
Provider Entity Type
Individual
Gender
Male
Address
148 Ennis Ln, Towanda, PA, 18623-6637
Phone Number
570-265-4769
Fax Number
Provider Enumeration Date
11/28/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
148 Ennis Ln
City
Towanda
State
Pennsylvania
Zip
18848-9198
Phone Number
570-265-4769
Fax Number
person
Provider Business Mailing Address Details
Address
148 Ennis Ln
City
Towanda
State
Pennsylvania
Zip
18848-9198
Phone Number
570-265-4769
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
PI124458 (Pennsylvania)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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