PEDIATRIC PRACTICES OF NORTHEASTERN PA; NPI #1730162678

Contact Information

PEDIATRIC PRACTICES OF NORTHEASTERN PA

1837 FAIR AVE
HONESDALE, PA 18431-2121

Phone: 570-253-5838
Fax: 570-253-1245
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Rural Health	261QR1300X	B4[14]	Rural Health Clinic
Pediatrics	208000000X	37	Physician/Pediatric Medicine

Indicates primary specialty

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NPI Profile & details for PEDIATRIC PRACTICES OF NORTHEASTERN PA

NPI # 1730162678

LBN Legal business name PEDIATRIC PRACTICES OF NORTHEASTERN PA

Authorized official ROBERT MORTON - (PARTNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/23/2005

Last updated 07/23/2019 - About 7 years ago

Identifiers

PA	Medicaid	100742260015
PA	Medicaid	100742260016
PA	Medicaid	100742260018
PA	Other	39-3887	CMS CERTIFICATION NUMBER

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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PEDIATRIC PRACTICES OF NORTHEASTERN PA

Contact Information

Specialty

Rural Health

Pediatrics

NPI Profile & details for PEDIATRIC PRACTICES OF NORTHEASTERN PA

Reviews for PEDIATRIC PRACTICES OF NORTHEASTERN PA