Lincoln Ave Medical

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

LINCOLN AVE MEDICAL

Practice address

100 Lincoln Ave
Carbondale, PA 18407-2116

Phone

(570) 284-5100

Fax

(570) 284-5103

NPI assigned

May 14, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christopher Hall

Title

Director of Billing

Phone

(772) 261-3422

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577404800000",
    "number": "1083092720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 NE JENSEN BEACH BLVD",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349577234",
            "telephone_number": "772-252-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LINCOLN AVE",
            "city": "CARBONDALE",
            "state": "PA",
            "postal_code": "184072116",
            "telephone_number": "570-284-5100",
            "fax_number": "570-284-5103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 Salem Ave",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "PA",
            "postal_code": "184072574",
            "country_code": "US",
            "telephone_number": "772-252-1235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LINCOLN AVE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "772-261-3422"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Erik Larson, ATC
• Gary L Latimer, D.C.
• Lehigh Valley Physician Group
• Robert John Lengyel, MD
• Melissa Fay Lesjack, OTR/L
• Danielle Lucas, M.ED, LBS, BC-ABA
• Terry Joseph Luma, M.D.
• Michael Henry Lynch, PSYCHOLOGIST
• Ashley Sue Machiesky, PA-C
• Evan James Maclusky, M.A.

• Specialist in Carbondale, PA
• Providers in Carbondale, PA by specialty
• Specialist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.