Healthcare Provider Details
I. General information
NPI: 1447414701
Provider Name (Legal Business Name): DONNA EGET PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/16/2008
Last Update Date: 01/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1208 ONEILL HWY
DUNMORE PA
18512-1709
US
IV. Provider business mailing address
1208 ONEILL HWY
DUNMORE PA
18512-1709
US
V. Phone/Fax
- Phone: 570-207-2612
- Fax: 570-207-2616
- Phone: 570-207-2612
- Fax: 570-207-2616
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | OS008478L |
| License Number State | PA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
DONNA
EGET
Title or Position: MEDICAL DIRECTOR
Credential: DO
Phone: 570-207-2612