Geisinger Clinic GYN Onc

Organization Active NPI Obstetrics Physician · Wilkes Barre, PA

NPI 1346208709 · NPPES record last updated Feb 28, 2019

Key facts

NPI
1346208709
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics Physician 207VX0000X
Legal business name
GEISINGER CLINIC GYN ONC
Practice address
1000 E Mountain Dr
Wilkes Barre, PA 17822-3034
Phone
(570) 826-7300
NPI assigned
May 3, 2006
Organization subpart
No

Authorized official

Name
Cindy Mull
Title
Director
Phone
(570) 271-6144

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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 (275 organizations share this tax ID)

Locations

Geisinger Clinic Physical Ter
Danville, PA 17822

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207VX0000X Yes
Gynecologic Oncology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207VX0201X
General Acute Care Hospital 282N00000X
Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
363A00000X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X
Advanced Practice Midwife
Group: 193200000X MULTI-SPECIALTY GROUP
367A00000X

Addresses

Primary practice location

1000 E Mountain Dr
Wilkes Barre, PA 17822-3034

Mailing address

100 N Academy Ave
Danville, PA 17822-3034

Other providers in Wilkes Barre, PA

All providers in Wilkes Barre, PA · Obstetrics Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.