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General NPI Number Information
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NPI Number | 1144709809
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Entity Type | Organization
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Legal Business Name | POCONO PSYCHIATRIC ASSOCIATES
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 08/13/2018
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Provider Practice Location Address
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Address Line | 526 INDEPENDENCE RD
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-9208
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Country | US
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Telephone | 570-424-2929
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Fax | 570-424-8501
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Provider Business Mailing Address
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Address Line | 526 INDEPENDENCE RD
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-9208
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Country | US
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Telephone | 570-424-2929
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Fax | 570-424-8501
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | KIMBERLY SUSAN BOCK
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Credential |
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Telephone | 570-424-2929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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