Organization
COUNTY OF WYOMING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG PORASKY (DIRECTOR)
(570) 836-3131
Entity
Organization
Contact information
Practice address
1 COURTHOUSE SQUARE, TUNKHANNOCK, PA 18657
(570) 836-3131
(570) 836-1639
Mailing address
PO BOX 29, TUNKHANNOCK, PA 18657
(570) 836-3131
(570) 836-1639
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016388030001
—
PA
Enumeration date
04/16/2007
Last updated
08/22/2020
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