Organization
CARDIAC ULTRASOUND, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN J KELLY RCS (PRESIDENT)
(570) 489-0171
Entity
Organization
Contact information
Practice address
631 SANDERSON ST, THROOP, PA 18512-1255
(570) 489-0171
(570) 489-0185
Mailing address
631 SANDERSON ST, THROOP, PA 18512-1255
(570) 489-0171
(570) 489-0185
Taxonomy
Speciality
Code
Description
License number
State
246XS1301X
Sonography Specialist/Technologist Cardiovascular
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014789030001
—
PA
01
—
028062600
BLACK LUNG
PA
01
—
PB0213
UNISOM MEDPLUS
PA
Enumeration date
04/04/2006
Last updated
04/24/2008
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