Organization
NEI AMBULATORY SURGERY CENTER INC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME W JORDON (MEDICAL DIRECTOR)
(570) 342-3145
Entity
Organization
Contact information
Practice address
204 MIFFLIN AVE, SCRANTON, PA 18503
(570) 342-3145
Mailing address
204 MIFFLIN AVE, SCRANTON, PA 18503
(570) 342-3145
(570) 344-1309
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069868
FIRST PRIORITY HEALTH
—
05
—
080011512060001
—
PA
01
—
303535
HIGHMARK BLUE SHIELD
PA
01
—
530966
AETNA
PA
Enumeration date
08/31/2006
Last updated
04/29/2010
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