Organization
PHYSICIANS HEALTH ALLIANCE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA KANE (COO)
(570) 969-9005
Entity
Organization
Contact information
Practice address
700 QUINCY AVE, SCRANTON, PA 18510-1724
(570) 969-9005
(570) 207-0706
Mailing address
1401 ELECTRIC ST, DUNMORE, PA 18509-2098
(570) 969-9005
(570) 207-0706
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007712910042
—
PA
01
—
2508986
BLUE SHIELD
PA
Enumeration date
06/04/2010
Last updated
10/31/2011
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