Healthcare Provider Details

I. General information

NPI: 1124435540
Provider Name (Legal Business Name): GEISINGER VIEWMONT SLEEP DISORDER CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 08/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 ASH ST SUITE C
SCRANTON PA
18509
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 570-969-0162
  • Fax: 570-207-5529
Mailing address:
  • Phone: 570-271-6144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number071801
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CINDY L MULL
Title or Position: DIRECTOR REVENUE MGMT
Credential:
Phone: 570-271-5555