| NPI | 1295620177 |
|---|---|
| Former Legal Business Name | BELLA GLOW MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOHN LAZAR Co Owner/President 570-560-8704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 207Q00000X Family Medicine | |
| 208600000X Surgery | |
| Enumeration Date | 2025-06-11 |
| Last Update Date | 2025-06-11 |