| NPI | 1336102268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BOYER Billing Manager 570-622-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| 291U00000X Clinical Medical Laboratory | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 207KA0200X Allergy & Immunology, Allergy | |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2016-02-10 |