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NPI Code Detail

MEDICARE: RADIOLOGY ASSOCIATES OF SCRANTON LLC

MEDICARE: RADIOLOGY ASSOCIATES OF SCRANTON LLC
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
12085R0202XDiagnostic Radiology PhysicianOS001940LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700879129
Entity Type Code : Organization
Provider Name (Legal Business Name) : RADIOLOGY ASSOCIATES OF SCRANTON LLC
Provider Business Mailing Address
First Line : PO BOX 249
Second Line :
City : DUNMORE
State : PA
Zip : 18512-0249
Country : US
Telephone Number : 570-969-4069
Fax Number : 570-969-4069
Provider Business Practice Location Address
First Line : 1800 MULBERRY ST
Second Line :
City : SCRANTON
State : PA
Zip : 18510-2369
Country : US
Telephone Number : 570-969-4069
Fax Number : 570-969-4069
Authorized Official
Title or Position : DIRECTOR
Name : BURTON MARKS
Credential : DO
Telephone Number : 570-450-4357
Provider Enumeration Date : 08/31/2005
Last Update Date : 07/10/2008

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Directions to “RADIOLOGY ASSOCIATES OF SCRANTON LLC ” Practice Location

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