| NPI | 1962538306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH HOLDREN CAO 570-271-5490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2008-06-30 |