Basic Information
Provider Information
NPI: 1184986952
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OWSIK
FirstName: GREGORY
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 13579
Address2:  
City: READING
State: PA
PostalCode: 196123579
CountryCode: US
TelephoneNumber: 4846280799
FaxNumber:  
Practice Location
Address1: 6TH AVENUE AND SPRUCE STREET
Address2:  
City: READING
State: PA
PostalCode: 196111428
CountryCode: US
TelephoneNumber: 4846283637
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/08/2012
LastUpdateDate: 06/09/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XMD454165PAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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