Gaia, Juan D

Gaia, Juan D is an sole proprietor health care provider with primary practice located at 451 3Rd Ave , Kingston PA 18704-5802. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Gaia, Juan D can be contacted via phone (570) 283-0528.

Contact Information

Primary practice address
451 3Rd Ave Kingston PA 18704-5802
Fax: (570) 283-5839
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD035138L Pennsylvania

Profile Details

NPI number 1972598720
LBN Legal business name Gaia, Juan D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 19th, 2005
Last updated Dec 22nd, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972598720 NPPES
Pennsylvania MEDICAID 0734150

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