| Medical Profesional Service, Pc | |
|
675 Wyoming Ave Kingston PA 18704-3831 | |
| (570) 288-4205 | |
| Not Available |
| Full Name | Medical Profesional Service, Pc |
|---|---|
| Speciality | General Practice |
| Location | 675 Wyoming Ave, Kingston, Pennsylvania |
| Authorized Official Name and Position | Philip James Mertz (DIRECTOR OF CLINICAL SERVICES) |
| Authorized Official Contact | 5702884205 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Profesional Service, Pc 675 Wyoming Ave Kingston PA 18704-3831 Ph: (570) 288-4205 | Medical Profesional Service, Pc 675 Wyoming Ave Kingston PA 18704-3831 Ph: (570) 288-4205 |
| NPI Number | 1821136227 |
|---|---|
| Provider Enumeration Date | 02/01/2007 |
| Last Update Date | 10/22/2010 |
| Medicare PECOS PAC ID | 1153395389 |
|---|---|
| Medicare Enrollment ID | O20040824000414 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821136227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Stanley Michael Stanish |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1033257407 PECOS PAC ID: 2062695919 Enrollment ID: I20110330000564 |
| Provider Name | Mark W Scinico |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396824470 PECOS PAC ID: 7315119997 Enrollment ID: I20180829000226 |
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