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General NPI Number Information
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NPI Number | 1528983780
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Entity Type | Organization
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Legal Business Name | MDS PENNSYLVANIA PC
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 17083 US-6
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City | SMETHPORT
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State | PA
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Zip | 16749
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Country | US
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Telephone | 917-740-3853
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Fax |
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Provider Business Mailing Address
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Address Line | 368 NEW HEMPSTEAD RD
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City | NEW CITY
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State | NY
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Zip | 10956-1900
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SHMUEL KOHN
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Credential |
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Telephone | 347-631-6775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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