Healthcare Provider Details
I. General information
NPI: 1841101672
Provider Name (Legal Business Name): BRIAN PEDONE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3450 HIGH POINT BLVD STE 160
BETHLEHEM PA
18017-7820
US
IV. Provider business mailing address
3183 SHAFERS SCHOOLHOUSE RD
STROUDSBURG PA
18360-7434
US
V. Phone/Fax
- Phone: 570-242-6913
- Fax:
- Phone: 570-242-6913
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: