National Provider Identifier Database

PEDIATRIC PRACTICES OF NORTHEASTERN PA
Rural Health


Contact Information

PEDIATRIC PRACTICES OF NORTHEASTERN PA
1837 FAIR AVE
HONESDALE, PA18431-2121
Phone: 570-253-5838
Fax: 570-253-1245
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X
Pediatrics 208000000X

* Indicates primary specialty

NPI Profile & details for PEDIATRIC PRACTICES OF NORTHEASTERN PA

NPI Number 1730162678
Legal business name
LBN
PEDIATRIC PRACTICES OF NORTHEASTERN PA
Authorized official ROBERT MORTON - (PARTNER)
Entity Organization
Organization subpart No
Enumeration date 11/23/2005
Last updated 07/23/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • PA Medicaid: 100742260015
  • PA Medicaid: 100742260016
  • PA Medicaid: 100742260018
  • PA Other: 39-3887 CMS CERTIFICATION NUMBER

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for PEDIATRIC PRACTICES OF NORTHEASTERN PA

There are currently no reviews for PEDIATRIC PRACTICES OF NORTHEASTERN PA


NPIdb - Home
v2.201