Organization
EAST PENN RHEUMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES L LUDIVICO M.D. (PRESIDENT)
(610) 868-1336
Entity
Organization
Contact information
Practice address
600 PLAZA CT, 447 OFFICE PLAZA, EAST STROUDSBURG, PA 18301-8263
(570) 424-9153
(570) 424-1046
Mailing address
701 OSTRUM ST, SUITE 501, FOUNTAIN HILL, PA 18015-1155
(610) 868-1336
(610) 332-3436
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD012628E
PA
Other
Enumeration date
02/06/2007
Last updated
08/22/2020
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