| NPI | 1790248466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY CAMAEREI Director Of Licensing 570-242-1768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2019-04-10 |