| NPI | 1659631406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDEN DANIEL SOLIMAN Doctor 570-587-1560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: PA DS-020886-L) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-05-25 |