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General NPI Number Information
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NPI Number | 1861750903
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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 | 04/26/2012
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Last Update Date | 04/26/2012
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Provider Practice Location Address
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Address Line | 175 E BROWN ST SUITE 114
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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 | 570-476-3506
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Fax | 570-420-2408
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Provider Business Mailing Address
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Address Line | PO BOX 824279
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City | PHILADELPHIA
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State | PA
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Zip | 19182-4279
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Country | US
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Telephone | 570-476-3141
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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 | 570-476-3141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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