MEDICARE: GUTHRIE CLINIC LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1568798155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUTHRIE CLINIC LTD

Provider Business Mailing Address
First Line	:	1 GUTHRIE SQ
Second Line	:
City	:	SAYRE
State	:	PA
Zip	:	18840-1625
Country	:	US
Telephone Number	:	570-888-5858
Fax Number	:	570-882-3023

Provider Business Practice Location Address
First Line	:	1 1ST ST
Second Line	:
City	:	WATKINS GLEN
State	:	NY
Zip	:	14891-1260
Country	:	US
Telephone Number	:	607-535-2403
Fax Number	:	607-535-2537

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPH A SCOPELLITI
Credential	:	MD
Telephone Number	:	570-888-5858

Provider Enumeration Date	:	11/02/2009
Last Update Date	:	11/02/2009

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