Organization
ST LUKE'S PHYSICIAN GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SMITA SATISH MODY MD (ANESTHESIOLOGIST)
(570) 645-8121
Entity
Organization
Contact information
Practice address
360 W RUDDLE ST, COALDALE, PA 18218-1027
(570) 645-8121
(570) 645-8875
Mailing address
360 W RUDDLE ST, COALDALE, PA 18218-1027
(570) 645-8121
(570) 645-8875
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD034814L
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD034814L
PA
Other
Enumeration date
11/17/2006
Last updated
12/18/2007
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