Organization
NORTHEAST PA NEURO-SPINE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP J HLAVAC M.D. (PHYSICIAN)
(570) 558-3540
Entity
Organization
Contact information
Practice address
414 E DRINKER ST, DUNMORE, PA 18512-2469
(570) 558-3540
(570) 558-3547
Mailing address
3 W OLIVE ST, STE 201, SCRANTON, PA 18508-2572
(570) 969-0663
(570) 969-9697
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1832581
BLUE SHIELD GROUP NUMBER
PA
Enumeration date
06/26/2006
Last updated
08/22/2020
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