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Organization
RECAREDO T BERBANO PC
Active
Organization
RECAREDO T BERBANO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RECAREDO TRINIDAD BERBANO JR. MD (MEDICAL DOCTOR OWNER)
(570) 718-0520
Entity
Organization
Contact information
Practice address
445 WYOMING AVENUE, KINGSTON, PA 18704
(570) 718-0520
(570) 718-0522
Mailing address
445 WYOMING AVENUE, KINGSTON, PA 18704
(570) 718-0520
(570) 718-0522
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD418104
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001887950
—
PA
Enumeration date
05/02/2007
Last updated
06/10/2008
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