Provider Demographics
NPI:1871114876
Name:MISHKO, AUSTIN JAMES (DPM)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:JAMES
Last Name:MISHKO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 MORGAN HILL RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-7086
Mailing Address - Country:US
Mailing Address - Phone:610-762-8386
Mailing Address - Fax:
Practice Address - Street 1:315 ROUTE 31 SOUTH
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-5656
Practice Address - Country:US
Practice Address - Phone:908-847-6858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-30
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC007099213ES0103X
NJ25MD00370800213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery