| NPI | 1063903151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN JADITZ Physician 570-586-8186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA OS006343L) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2023-01-23 |