STRP Faculty Service

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

STRP FACULTY SERVICE

Practice address

640 Madison Ave
Scranton, PA 18510-1607

Phone

(570) 961-5670

Fax

(570) 961-5991

NPI assigned

Sep 23, 2005

Organization subpart

No

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

Authorized official

Name

Elidoro Primero

Title

Chief Financial Officer

Phone

(570) 941-0630

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Scranton Temple Residency Program3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Scranton Temple Residency Program

  • Primary Care Clinic/Center
  • Scranton, PA
  • NPI 1538309950
  NPD tax ID
• Scranton Temple Residency Program Faculty Services

  • Internal Medicine Physician
  • Scranton, PA
  • NPI 1932195492
  NPD tax ID

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1851387013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "746 JEFFERSON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185101624",
            "telephone_number": "570-343-2383",
            "fax_number": "570-963-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 MADISON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185101607",
            "telephone_number": "570-961-5670",
            "fax_number": "570-961-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRP FACULTY SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PRIMERO",
        "authorized_official_first_name": "ELIDORO",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "570-941-0630"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0663952",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ian James Stout, DPT, ATC
• Kaitlyn Mary Stratton, LSW
• Martina Straub
• Cecilia Christine Strauch, MD
• Christine Marie Stroka, D.O.
• Heather Stuart, LPC
• Khrizma Stubbs, DPM
• Michelle Ann Styer
• Kamma Stylinski
• Stephen Michael Stylinski, PT

• Internal Medicine Physician in Scranton, PA
• Providers in Scranton, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.