| NPI | 1346838984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN SHEYDWASSER Authorized Official 570-406-6063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2021-11-23 |