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Organization
NORTHEAST CRITICAL CARE LTD
Active
Organization
NORTHEAST CRITICAL CARE LTD
Active
Parent organization
000000
Other names
NCC Clinical Lab, Valley Primary Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
000000
Authorized official
DAVID B KASPRZAK CRNP (CEO)
(570) 657-1634
Entity
Organization
Contact information
Practice address
229 W BROAD ST, TAMAQUA, PA 18252-1818
(570) 657-1634
(570) 645-3397
Mailing address
10 W WHITE BEAR DR, SUMMIT HILL, PA 18250-1728
(570) 657-1634
(570) 645-3397
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Enumeration date
05/18/2022
Last updated
05/18/2022
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