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Organization

PALMERTON PEDIATRICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MIRA SLIZOVSKY M.D. (PRESIDENT)
(610) 826-1166
Entity
Organization

Contact information

Practice address
217 FRANKLIN AVE, PALMERTON, PA 18071-1521
(610) 826-1166
(610) 824-1521
Mailing address
217 FRANKLIN AVE, PALMERTON, PA 18071-1521
(610) 826-1166
(610) 824-1521

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G79638
UPIN
PA
Enumeration date
11/30/2010
Last updated
11/30/2010
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