Organization
DIAGNOSTIC BREAST CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN F KOPEN MD (PRESIDENT)
(570) 718-6690
Entity
Organization
Contact information
Practice address
190 WELLES ST, FORTY FORT, PA 18704-4968
(570) 718-6690
Mailing address
190 WELLES ST, FORTY FORT, PA 18704-4968
(570) 718-6690
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010639010001
—
PA
01
—
1549295
HIGHMARK BLUE SHIELD
PA
01
—
221883
FIRST PRIORITY
PA
01
—
231553
HEALTH AMERICA
PA
01
—
3416377
AETNA
PA
01
—
657C
GEISINGER HEALTH PLAN
PA
01
—
DB9358
RAILROAD MEDICARE
PA
Enumeration date
06/28/2006
Last updated
03/24/2008
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