Organization
PEDIATRIC PRACTICES OF NORTHEASTERN PA
Active
Other names
Pediatric Practices of Northeastern PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT MORTON MD (PARTNER)
(570) 253-5838
Entity
Organization
Contact information
Practice address
62 INDUSTRIAL PARK RD, LAKE ARIEL, PA 18436-5606
(570) 689-7565
(570) 689-4803
Mailing address
1837 FAIR AVE, HONESDALE, PA 18431-2121
(570) 689-7565
(570) 689-4803
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007422260016
—
PA
01
—
39-3888
CMS CERTIFICATION NUMBER
PA
Enumeration date
02/02/2010
Last updated
07/23/2019
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