NPI | 1104878453 |
---|---|
Entity Type | Organization |
Authorized Contact | CINDY L MULL System Director 570-271-6603 |
Organization Subpart ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
Additional Taxonomies | 363A00000X Physician Assistant |
363L00000X Nurse Practitioner | |
Enumeration Date | 2006-05-16 |
Last Update Date | 2021-09-30 |