| NPI | 1114977626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL System Director Credentialing 570-271-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine | |
| 208000000X Pediatrics | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 291U00000X Clinical Medical Laboratory | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2022-08-23 |