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Organization

RECAREDO T BERBANO PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RECAREDO TRINIDAD BERBANO JR. MD (MEDICAL DOCTOR OWNER)
(570) 718-0520
Entity
Organization

Contact information

Practice address
445 WYOMING AVENUE, KINGSTON, PA 18704
(570) 718-0520
(570) 718-0522
Mailing address
445 WYOMING AVENUE, KINGSTON, PA 18704
(570) 718-0520
(570) 718-0522

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD418104
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001887950
PA
Enumeration date
05/02/2007
Last updated
06/10/2008
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