| NPI | 1083090823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN M CICCHIELLO Executive Director 570-875-9434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA TP006931C) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA TP 006931C) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP009838) | |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2015-08-04 |