Scranton Temple Residency Program Faculty Services

LBN: Scranton Temple Residency Program Faculty Services
Scranton Temple Residency Program Faculty Services is an health care organization with primary practice located at 640 Madison Ave , Scranton PA 18510-1624. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Scranton Temple Residency Program Faculty Services can be contacted via phone (570) 941-0630, or through Primero, Elisoro via phone (570) 941-0630.

Contact Information

Primary practice address
640 Madison Ave Scranton PA 18510-1624
Phone: (570) 941-0630
Fax: (570) 941-0648
Website:
Map and Directions
Authorized official contact:
Name: Primero, Elisoro
Phone: (570) 941-0630

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X

Profile Details

NPI number 1932195492
LBN Legal business name Scranton Temple Residency Program Faculty Services
DBA Doing business as
Authorized official Primero, Elisoro
Entity Organization
Organization subpart 1 No
Enumeration date Sep 21st, 2005
Last updated Jul 24th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932195492 NPPES
Pennsylvania MEDICAID 001508252

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