Basic Information
| Provider Information | |||||||||
| NPI: | 1811286024 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUCHNIK | ||||||||
| FirstName: | EUGENE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 ELMWOOD AVE BOX MED | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146420001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852754912 | ||||||||
| FaxNumber: | 5852762144 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 GRAMPIAN BLVD | ||||||||
| Address2: | |||||||||
| City: | WILLIAMSPORT | ||||||||
| State: | PA | ||||||||
| PostalCode: | 177011907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5703268470 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2011 | ||||||||
| LastUpdateDate: | 10/07/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 267892 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 208M00000X | 267892 | NY | N | Allopathic & Osteopathic Physicians | Hospitalist | 207RX0202X | MD457823 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
No ID Information.