Organization
CARDIOVASCULAR DIAGNOSTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD GIBBONS M.D. (PRESIDENT)
(570) 654-6759
Entity
Organization
Contact information
Practice address
1099 S TOWNSHIP BLVD, JENKINS TWP, PA 18640-3247
(570) 654-6759
(570) 655-5160
Mailing address
1099 S TOWNSHIP BLVD, JENKINS TWP, PA 18640-3247
(570) 654-6759
(570) 655-5160
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
813246
FIRST PRIORITY HEALTH
PA
Enumeration date
11/30/2007
Last updated
11/30/2007
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