| NPI | 1770650962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES THOMAS GRAD Business Manager 570-348-1130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology | |
| 208000000X Pediatrics | |
| 207Q00000X Family Medicine | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2016-03-03 |