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General NPI Number Information
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NPI Number | 1679752331
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Entity Type | Organization
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Legal Business Name | POCONO ORTHOPEDIC CONSULTANTS, INC
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 500 PLAZA CT STE D
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-8262
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Country | US
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Telephone | 570-424-5180
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Fax |
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Provider Business Mailing Address
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Address Line | 500 PLAZA CT STE D
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-8262
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Country | US
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Telephone | 570-424-5180
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEORGE A PRIMIANO
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Credential |
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Telephone | 570-424-5180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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