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Organization
NORTHEAST KNEE AND JOINT INSTITUTE, LLC.
Active
Organization
NORTHEAST KNEE AND JOINT INSTITUTE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN ROMAN MD (OWNER)
(570) 213-5221
Entity
Organization
Contact information
Practice address
3832 YALICK PLAZA ROUTE 415, UNIT 7, DALLAS, PA 18612-7753
(570) 213-5221
(570) 227-3316
Mailing address
PO BOX 3367, WILLIAMSPORT, PA 17701-0367
(570) 213-5221
(570) 227-3316
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
NULL
Other
Enumeration date
11/08/2017
Last updated
07/15/2019
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