Individual
COREY ADRIAN GENTEEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
101 POCONO CMNS STE 101, STROUDSBURG, PA 18360-7599
(570) 872-9955
(570) 872-9255
Mailing address
101 POCONO CMNS STE 101, STROUDSBURG, PA 18360-7599
(570) 827-9955
(570) 872-9255
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA003405L
PA
363AM0700X
Medical Physician Assistant
Primary
MA003405L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00148935
RAILROAD MEDICARE
PA
Enumeration date
06/08/2006
Last updated
07/18/2025
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