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NPI 1104804889

NPI 1104804889 : RADIATION MEDICINE SPECIALISTS OF NORTHEAST PENNSYLVANIA P C : FORTY FORT, PA

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General NPI Number Information
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    NPI Number           |    1104804889
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    Entity Type          |    Organization 
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    Legal Business Name  |    RADIATION MEDICINE SPECIALISTS OF NORTHEAST PENNSYLVANIA P C 
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Dates
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    Enumeration Date     |    01/04/2006
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    Last Update Date     |    07/21/2022
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Provider Practice Location Address
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    Address Line         |    190 WELLES ST 
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    City                 |    FORTY FORT
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    State                |    PA
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    Zip                  |    18704-4968
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    Country              |    US
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    Telephone            |    570-714-8686
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    Fax                  |    570-714-8666
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Provider Business Mailing Address
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    Address Line         |    PO BOX 515490 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90051-6790
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    Country              |    US
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    Telephone            |    310-335-4000
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. NORMAN  SCHULMAN 
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    Credential           |    MD
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    Telephone            |    570-714-8686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2085R0001X
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    Taxonomy Name        |    Radiation Oncology Physician
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    License Number       |    
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    License Number State |    PA
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