Organization
OPEN ARMS INTERNAL MEDICINE & PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL LEWIS GOMBOSI MD (OWNER)
(570) 244-1877
Entity
Organization
Contact information
Practice address
3155 LYCOMING CREEK RD, WILLIAMSPORT, PA 17701-1032
(570) 244-1877
Mailing address
5271 STATE ROUTE 973 E, COGAN STATION, PA 17728-8500
(570) 244-1877
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
MD043621L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528078433
INDIVIDUAL NPI
PA
Enumeration date
11/14/2017
Last updated
11/14/2017
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