Organization
POCONO EMERGENCY PHYSICIANS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER FAVINI MD (MEDICAL DIRECTOR)
(570) 476-3625
Entity
Organization
Contact information
Practice address
206 E BROWN ST, EAST STROUDSBURG, PA 18301-3006
(570) 476-3353
(570) 421-6801
Mailing address
1000 RIVER RD, SUITE 100, CONSHOHOCKEN, PA 19428-2439
(610) 834-2828
(610) 824-2862
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
N/A
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017968370002
—
PA
01
—
PO572711
BLUE SHIELD
PA
Enumeration date
05/26/2006
Last updated
08/25/2008
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