Healthcare Provider Details

I. General information

NPI: 1841438264
Provider Name (Legal Business Name): THE POTTSVILLE PA ENDOSCOPY ASC, LLP (CRNA)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 01/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 TUNNEL RD STE 103
POTTSVILLE PA
17901-3875
US

IV. Provider business mailing address

PO BOX 390
SCRANTON PA
18501-0390
US

V. Phone/Fax

Practice location:
  • Phone: 570-622-6520
  • Fax: 570-622-6525
Mailing address:
  • Phone: 570-346-7797
  • Fax: 770-666-9078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: DR. ARMIT P NARULA
Title or Position: DIRECTOR
Credential: MD
Phone: 570-346-7797