NPI | 1538714092 |
---|---|
Entity Type | Organization |
Authorized Contact | JOSEPH VICCICA Office Manager 570-299-0037 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 208D00000X General Practice |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2019-08-01 |
Last Update Date | 2024-09-26 |