Organization
NORTHEAST DERMATOPATHOLOGY INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK BRIAN SZYMANSKI M.D. (OWNER)
(570) 586-4400
Entity
Organization
Contact information
Practice address
405 S STATE ST, CLARKS SUMMIT, PA 18411-1542
(570) 586-4400
(570) 587-5531
Mailing address
405 S STATE ST, CLARKS SUMMIT, PA 18411-1542
(570) 586-4400
(570) 587-5531
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
029481
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014008140001
—
PA
01
—
P00238091
RAILROAD MEDICARE
PA
Enumeration date
02/09/2006
Last updated
03/09/2018
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