| NPI | 1710617857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON PISARCIK Chief Financial Officer 570-825-6425 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2025-09-04 |