Healthcare Provider Details
I. General information
NPI: 1023344611
Provider Name (Legal Business Name): GUTHRIE CLINIC LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/02/2009
Last Update Date: 11/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9768 LIBERTY DR
PAINTED POST NY
14870-9094
US
IV. Provider business mailing address
1 GUTHRIE SQ
SAYRE PA
18840-1625
US
V. Phone/Fax
- Phone: 607-937-4900
- Fax: 607-937-4940
- Phone: 570-888-5858
- Fax: 570-882-3023
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOSEPH
A
SCOPELLITI
Title or Position: PRESIDENT
Credential: MD
Phone: 570-888-5858