Healthcare Provider Details

I. General information

NPI: 1265833321
Provider Name (Legal Business Name): GEISINGER CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2014
Last Update Date: 11/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 SCRANTON-CARBONDALE HWY
SCRANTON PA
18508
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822
US

V. Phone/Fax

Practice location:
  • Phone: 570-207-5502
  • Fax:
Mailing address:
  • Phone: 570-271-6621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

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 CYCLE
Credential:
Phone: 570-271-6603