| NPI | 1679338685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN GUERRIERO Owner Provider 570-616-8589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2024-09-16 |