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NPI Code Detail

MEDICARE: GREATER HAZLETON RADIOLOGY ASSOCIATES

MEDICARE: GREATER HAZLETON RADIOLOGY ASSOCIATES
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
1174400000XSpecialist

General Provider Information

NPI Number : 1851348478
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREATER HAZLETON RADIOLOGY ASSOCIATES
Provider Business Mailing Address
First Line : 101 GREENWOOD AVE
Second Line : SUITE 151
City : JENKINTOWN
State : PA
Zip : 19046-2627
Country : US
Telephone Number : 215-379-8458
Fax Number : 215-379-8461
Provider Business Practice Location Address
First Line : 1000 ALLIANCE DR
Second Line : 110
City : HAZLETON
State : PA
Zip : 18202-3234
Country : US
Telephone Number : 570-459-4674
Fax Number :
Authorized Official
Title or Position : CREDENTIALING COORDINATOR
Name : VICTORIA SANCHEZ
Credential :
Telephone Number : 215-379-8458
Provider Enumeration Date : 05/28/2006
Last Update Date : 08/22/2020

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Directions to “GREATER HAZLETON RADIOLOGY ASSOCIATES ” Practice Location

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