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Organization
PITTSTON MEDICAL ASSOCIATES, LTD
Active
Organization
PITTSTON MEDICAL ASSOCIATES, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD P GIBBONS JR. MD (PRESIDENT)
(570) 654-6759
Entity
Organization
Contact information
Practice address
1099 S TOWNSHIP BLVD, SUITE F, PITTSTON, PA 18640-3247
(570) 654-6759
Mailing address
1099 S TOWNSHIP BLVD, SUITE F, PITTSTON, PA 18640-3247
(570) 654-6759
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016959600001
—
PA
01
—
00187
FIRST PRIORITY HEALTH
PA
01
—
698161
HIGHMARK BLUE SHIELD
PA
Enumeration date
03/20/2006
Last updated
03/23/2011
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