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General NPI Number Information
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NPI Number | 1659698249
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Entity Type | Organization
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Legal Business Name | NORTHSTAR NONURGENT CARE
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | 2733 BUTTERMILK RD
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City | HELLERTOWN
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State | PA
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Zip | 18055-3358
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Country | US
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Telephone | 610-417-1881
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Fax |
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Provider Business Mailing Address
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Address Line | 2733 BUTTERMILK RD
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City | HELLERTOWN
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State | PA
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Zip | 18055-3358
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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 | MD
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Name | DR. GEORGE MANJA
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Credential |
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Telephone | 610-417-1881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MD058653-L
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License Number State | PA
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