is a Clinic/center in Wilkes Barre, Pennsylvania. practices all healthcare services and medical treatments related to Clinic/center. The NPI Number for is 1649221219. The last update date is .
's current location address is 33 E Northampton St, Wilkes Barre, Pennsylvania. You can contact this provider via phone number 5708293489 and fax number 5708297781. The mailing address for is 33 E Northampton St, Wilkes Barre, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 33 E Northampton St, Wilkes Barre, Pennsylvania |
| Phone Number | 5708293489 |
| Fax Number | 5708297781 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1649221219 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 33 E Northampton St |
|---|---|
| City | Wilkes Barre |
| State | Pennsylvania (PA) |
| Post Code | 187012406 |
| Phone Number | 5708293489 |
| Fax Number | 5708297781 |
Provider's Primary Taxonomy Detail
| Speciality | Clinic/center |
|---|---|
| Taxonomy | 261Q00000X |
|
Definition: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1007592970013 | PA | -- | |
| 2100928 | PA | CIGNA BEHAVIORL HEALTH | |
| 999017 | PA | BC/BS OF NEPA | |
| 803427 | PA | FIRST PRIORITY HEALTH | |
| 317559 | PA | BLUE SHIELD |
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