| NPI | 1588019095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HAZZOURI Medical Director 570-961-6030 |
| Organization Subpart ? | |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: PA 112193) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-05-03 |