Healthcare Provider Details

I. General information

NPI: 1023244035
Provider Name (Legal Business Name): POCONO ORTHPOPAEDICS SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2009
Last Update Date: 05/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E BROWN ST
EAST STROUDSBURG PA
18301-3006
US

IV. Provider business mailing address

206 E BROWN ST POCONO HEALTHCARE MANAGEMENT
EAST STROUDSBURG PA
18301-3006
US

V. Phone/Fax

Practice location:
  • Phone: 570-895-2300
  • Fax: 570-839-1094
Mailing address:
  • Phone: 570-420-4951
  • Fax: 570-476-3754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JANE RAGONE
Title or Position: MANAGER
Credential:
Phone: 570-420-4970