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Organization

EAST STROUDSBURG

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ZACHARY BRAUNSTEIN (STUDENT)
(717) 683-2873
Entity
Organization

Contact information

Practice address
1806 W MAIN ST, APT 201, STROUDSBURG, PA 18360-1028
(203) 312-4811
Mailing address
1806 W MAIN ST, APT 201, STROUDSBURG, PA 18360-1028

Taxonomy

Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary

Other

Enumeration date
12/17/2015
Last updated
12/17/2015
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