Healthcare Provider Details

I. General information

NPI: 1992785109
Provider Name (Legal Business Name): PAMELA JEAN HERRINGTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 E CENTRAL AVE
JERSEY SHORE PA
17740-6979
US

IV. Provider business mailing address

345 E CENTRAL AVE
JERSEY SHORE PA
17740-6979
US

V. Phone/Fax

Practice location:
  • Phone: 570-873-3440
  • Fax: 570-873-3572
Mailing address:
  • Phone: 570-873-3440
  • Fax: 570-873-3572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD044863L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: