Healthcare Provider Details

I. General information

NPI: 1730104969
Provider Name (Legal Business Name): NORTHWOOD HEALTH SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 10/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3729 EASTON NAZARETH HWY SUITE 202
EASTON PA
18045-8344
US

IV. Provider business mailing address

3729 EASTON NAZARETH HWY SUITE 202
EASTON PA
18045-8344
US

V. Phone/Fax

Practice location:
  • Phone: 610-252-7410
  • Fax: 610-252-7380
Mailing address:
  • Phone: 610-252-7410
  • Fax: 610-252-7380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. MELISSA KLINE
Title or Position: MANAGER
Credential:
Phone: 570-424-1500