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Organization

PRIMEMED PC

Active
Find providers by NPI
Organization

PRIMEMED PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MYRON SIDLOSKI (CHIEF ADMINISTRATIVE OFFICER)
(570) 558-7412
Entity
Organization

Contact information

Practice address
5 MORGAN HWY, SUITE 6, SCRANTON, PA 18508-2641
(570) 558-7414
(570) 207-4287
Mailing address
5 MORGAN HWY, SUITE 6, SCRANTON, PA 18508-2641
(570) 558-7414
(570) 207-4287

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
225100000X
Physical Therapist
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007508180046
—
PA
05
—
1007508180047
—
PA
Enumeration date
07/06/2006
Last updated
02/18/2014
About Stedi
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