PEDIATRIC PRACTICES OF NORTHEASTERN PA (NPI# 1033441092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033441092 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC PRACTICES OF NORTHEASTERN PA |
| Other Organization Name | PEDIATRIC PRACTICES OF NORTHEASTERN PA |
| Practice Address |
62 Industrial Park Rd Lake Ariel PA 18436-5606 |
| Mailing Address |
1837 Fair Ave Honesdale PA 18431-2121 |
| Practice Telephone | 5706897565 |
| Practice Fax Number | 5706894803 |
| Mailing Telephone | 5706897565 |
| Mailing Fax Number | 5706894803 |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2019-07-23 |
| Authorized Official Name | DR. ROBERT MORTON (PARTNER) |
| Authorized Official Telephone | 5702535838 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1007422260016 | 05 | |
| PA | CMS CERTIFICATION NUMBER | 39-3888 | 01 |
| Other Name | Type Code |
|---|---|
| Pediatric Practices of Northeastern PA | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1837 Fair Ave, Honesdale, PA 184312121 | 5702535838 | 5702536678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578895538 | Pediatric Practices of Northeastern Pa | Pediatrics | 27b Woodlands Dr, Waymart, PA 18472-9366 | 2010-02-02 |
| 1861722902 | Pediatric Practices of Northeastern Pa | Pediatrics | 510 Route 6 and 209, Suite 103, Milford, PA 18337-7615 | 2010-01-13 |
| 1730162678 | Pediatric Practices of Northeastern Pa | Pediatrics | 1837 Fair Ave, Honesdale, PA 18431-2121 | 2005-11-23 |
| Street Address |
62 INDUSTRIAL PARK RD |
| City | LAKE ARIEL |
| State | PA |
| Zip Code | 18436-5606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265414296 | Theresa A Lafranco | Pediatrics | 62 Industrial Park Rd, Lake Ariel, PA 18436 | 2005-11-16 |
| 1598316762 | Milagros Ramos-campesi | Nurse Practitioner | 62 Industrial Park Rd, Lake Ariel, PA 18436-5606 | 2019-09-27 |
| 1194377341 | Wayne Memorial Community Health Centers | Pediatrics | 62 Industrial Park Rd, Lake Ariel, PA 18436-5606 | 2019-07-09 |
| 1154855542 | Larryl L Damon Jr. | Pediatrics | 62 Industrial Park Rd, Lake Ariel, PA 18436-5606 | 2017-04-12 |
| 1346439981 | Lee Mcdonald Defazio | Nurse Practitioner | 62 Industrial Park Rd, Lake Ariel, PA 18436-5606 | 2007-10-19 |
| 1922183375 | Basya Marcus | Pediatrics | 62 Industrial Park Rd, Lake Ariel, PA 18436-5606 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467993626 | Kelsey Russo | Specialist/Technologist | 2362 Tanglewood Lane, Lake Ariel, PA 18436 | 2017-03-20 |
| 1548716145 | Little Creek Out Patient Services LLC | Clinic/Center | 518 Easton Turnpike, Lake Ariel, PA 18436 | 2016-09-01 |
| 1720460454 | Erin Mattox | Physical Therapy Assistant | 1089 Mustang Road, Lake Ariel, PA 18436 | 2015-06-18 |
| 1033373485 | Katherine Rosalie Schloesser | Dentist | 554 Hamlin Highway, Lake Ariel, PA 18436 | 2008-07-15 |
| 1962676494 | Marcela Blair | Social Worker | 369 Renwood Court, Lake Ariel, PA 18436 | 2008-04-16 |
| 1407048689 | Micro Diagnostics Imaging Inc | Durable Medical Equipment & Medical Supplies | 473 Easton Turnpike, Suite G, Lake Ariel, PA 18436 | 2007-08-13 |
| 1780667097 | Robert J. Morton | Pediatrics | 62 Industrial Park Road, Lake Ariel, PA 18436 | 2005-11-22 |
| 1295268365 | Sabrina Noelle Cimerol | Student in an Organized Health Care Education/Training Program | 358 Hamlin Hwy, Suite 2, Lake Ariel, PA 18436 | 2017-04-06 |
| 1356632236 | Brian A. Barland | Pharmacist | 639 Hamlin Hwy, Lake Ariel, PA 18436 | 2011-04-26 |
| 1063726255 | Bijan Reza Ahmadzadeh | Dentist | 358 Hamlin Hwy, Suite 2, Lake Ariel, PA 18436-0000 | 2010-07-30 |
| Find all providers in zip 18436 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266029 | Upmc Kane | Clinic/Center | 511 South Main Street, Sheffield, PA 16347 | 2020-08-17 |
| 1174176796 | Cornerstone Coordinated Health Care, LLC | Clinic/Center | 2114 Centre St, Ashland, PA 17921-1015 | 2019-07-23 |
| 1053873976 | Titusville Area Hospital | Clinic/Center | 10926 State Highway 18, Conneaut Lake, PA 16316-3526 | 2019-04-01 |
| 1760954721 | The Carbon-schuylkill Community Hospital, Inc. | Clinic/Center | 100 W Patterson St, Suite 201, Lansford, PA 18232 | 2018-12-31 |
| 1548761935 | The Carbon-schuylkill Community Hospital, Inc. | Clinic/Center | 411 S Shenandoah Rd, Ringtown, PA 17967-9432 | 2018-02-22 |
| 1790191948 | Dlp Conemaugh Physician Practices LLC | Clinic/Center | 1609 W. Pitt St., Jennerstown, PA 15547 | 2014-07-09 |
| 1922429133 | Tyrone Hospital | Clinic/Center | 221 Hospital Dr Ste 6, Tyrone, PA 16686-1826 | 2013-12-16 |
| 1124456157 | Tyrone Hospital | Clinic/Center | 125 Spring Street, Houtzdale, PA 16651 | 2013-10-30 |
| 1831466937 | Conemaugh Health Initiatives | Clinic/Center | 1611 W. Pitt Street, Jennerstown, PA 15547-0190 | 2011-11-18 |
| 1245419639 | Pinnacle Health Partners Inc. | Clinic/Center | Hc 1 Box 2170, Tafton, PA 18464-9714 | 2007-11-01 |
| Find all providers with the same taxonomy | ||||
| City | LAKE ARIEL |
| Zip Code | 18436 |
Please comment or provide details below to improve the information on PEDIATRIC PRACTICES OF NORTHEASTERN PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.