| NPI | 1104953330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL System Director Enrollment 570-271-6144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2019-06-12 |