# NORTHEAST PHYSICIAN HOUSECALLS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790009488
- **Authorized official:** DR. KURT P MORAN M.D. (PRESIDENT)
- **Authorized official phone:** (570) 840-7056

## Contact information

- **Practice address:** 52 DUNDAFF ST, CARBONDALE, PA 18407-1879
- **Practice address phone:** (570) 650-7282
- **Mailing address:** 200 WOODLANDS EDGE DR, OLYPHANT, PA 18447-9793
- **Mailing address phone:** (570) 650-7282

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 03/24/2010
- **Last updated:** 03/24/2010