| NPI | 1740691955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEDRO GUZMAN Director 570-497-4419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: PA MD441284) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2020-02-14 |