Jersey Shore Hospital Foundation, Inc
Organization Active NPI Family Medicine Physician · Avis, PA
NPI 1417019498 · NPPES record last updated Apr 3, 2014
Key facts
- NPI
- 1417019498
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- JERSEY SHORE HOSPITAL FOUNDATION, INC
- Practice address
- 104 East Central Avenue
Avis, PA 17721 - Phone
- (570) 753-8620
- Fax
- (570) 753-5489
- NPI assigned
- Dec 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Carey W. Plummer, CEO
- Title
- Ceo
- Phone
- (570) 398-3101
Practitioners 18
-
Barbara M Buckley, PA-C
-
Darius Abadi, D.O.
-
Donald Desantis, M.D.
-
Natalie Gabinskiy, PA-C
-
Nadine Marie McGraw, PA-C
-
Chelsi L. Serafini, P.A.C.
-
Alan Sherman, M.D.
-
Carmen Spinney, M.D.
-
Todd M Stefan, MD
-
John F Turner, MD
-
Alexis A Yakich, PA-C
-
Steven S. Davis, M.D.
-
Dennis Mamaril, MD
-
Nancy Quintero, D.O.
National Provider Directory
Locations
529 High St
Ste 2
Lock Haven, PA 17745
Phone (570) 748-8034
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Internal Medicine Physician |
207R00000X | |||
| Orthopaedic Surgery Physician |
207X00000X | |||
| Surgery Physician |
208600000X |
Addresses
Primary practice location
104 East Central Avenue
Avis, PA 17721
Mailing address
104 East Central Avenue
PO Box 430
Avis, PA 17721
Phone (570) 753-8620
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CL3010 | Other | PA | RAILROAD MEDICARE |
| 1001557500008 | Medicaid | PA | |
| 220807 | Other | PA | FIRST PRIORITY HEALTH |
| 5938 | Other | PA | AETNA |
| C2CE | Other | PA | GEISINGER HEALTH PLAN |
| 555630 | Other | PA | BLUE CROSS BLUE SHIELD |
Other names
- Jersey Shore Medical Associates
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All providers in Avis, PA · Family Medicine 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 Apr 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.