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General NPI Number Information
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NPI Number | 1861712036
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Entity Type | Organization
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Legal Business Name | MONROE COUNTY FAMILY HEALTH CENTER
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Dates
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Enumeration Date | 06/10/2010
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Last Update Date | 06/10/2010
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Provider Practice Location Address
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Address Line | 175 E BROWN ST SUITE 204
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-3098
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Country | US
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Telephone | 570-369-6482
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Fax | 570-421-1833
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Provider Business Mailing Address
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Address Line | 175 E BROWN ST SUITE 204
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-3098
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Country | US
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Telephone | 570-369-6482
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Fax | 570-421-1833
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SHERRY ROTH
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Credential |
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Telephone | 570-369-6482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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