Geisinger Clinic
Organization Active NPI Pediatrics Physician · Pittston, PA
NPI 1144680992 · NPPES record last updated Mar 7, 2016
Key facts
- NPI
- 1144680992
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- GEISINGER CLINIC
- Practice address
- 57 N Main St
Pittston, PA 18640-1915 - Phone
- (557) 060-2562
- Fax
- (570) 602-5621
- NPI assigned
- Mar 7, 2016
- Organization subpart
- No
Authorized official
- Name
- Cindy L Mull
- Title
- Director of Credentialing
- Phone
- (570) 271-6603
Corporate family (same tax ID) 24
Practitioners 3
-
Stephen Braun, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040130000518 | PA | Part B Supplier - Clinic/Group Practice | 5395657001 |
Receives reassigned benefits from 5,323 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Geisinger Clinic Sunbury
Locations
57 N Main St
Pittston, PA 18640
Phone (570) 602-5620
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | Yes |
Addresses
Primary practice location
57 N Main St
Pittston, PA 18640-1915
Mailing address
100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-5555
Other names
- Partners in Pediatrics
Other providers in Pittston, PA
- Tatiana C Franco
- Khyla Marilyn Fritz
- Amy Gale
- Lynnae Galella
- Deborah M Gdovin
- Geisinger Clinic
- Geisinger Clinic
- Geisinger Clinic
- Geisinger Wyoming Valley Dba Medic 303
- Geisinger Wyoming Valley Medical Center
All providers in Pittston, PA · Pediatrics Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.