| NPI | 1205270410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAIZMOHAMED M MANSURI Physician 570-589-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: PA MD427029) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2013-04-19 |