Individual
DR. RENE L PRISTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 E MOUNTAIN BLVD, WILKES BARRE, PA 18711-0027
(570) 808-7850
(570) 808-7855
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS013690
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000192771
UNISON
PA
05
—
0108928
—
NJ
05
—
1016689100001
—
PA
01
—
1554146
GATEWAY
PA
01
—
1865764
HIGHMARK
PA
01
—
2724601000
IBC
PA
01
—
50060462
CAPITAL ADVANTAGE
PA
Enumeration date
07/21/2005
Last updated
06/09/2021
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