Organization
NORTHEASTERN PENNSYLVANIA CARDIOLOGY ASSOCIATES LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN H ELLIS IV M.D. (PHYSICIAN ADMINISTRATOR)
(570) 823-1111
Entity
Organization
Contact information
Practice address
667 N RIVER ST, SUITE 201, PLAINS, PA 18705-1013
(570) 823-1111
(570) 824-9044
Mailing address
667 N RIVER ST, SUITE 201, PLAINS, PA 18705-1013
(570) 823-1111
(570) 824-9044
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1722207
—
PA
01
—
365638
HIGMARK BLUE SHIELD
PA
Enumeration date
02/09/2007
Last updated
08/22/2020
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