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Organization
PHYSICIANS HEALTH ALLIANCE INC
Active
Organization
PHYSICIANS HEALTH ALLIANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA KANE (COO)
(570) 969-9005
Entity
Organization
Contact information
Practice address
748 QUINCY AVE, SUITE 1A, SCRANTON, PA 18510-1739
(570) 347-9600
(570) 342-0681
Mailing address
1401 ELECTRIC ST, DUNMORE, PA 18509-2098
(570) 969-9005
(570) 207-0706
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
208000000X
Pediatrics Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007712910019
—
PA
01
—
812571
BLUE SHIELD
PA
Enumeration date
01/12/2006
Last updated
11/01/2011
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