| Wyoming Valley Infectious Disease Assoc, Pc | |
|
545 N River St Suite 205 Wilkes Barre PA 18702-2600 | |
| (570) 822-6036 | |
| (570) 829-1520 |
| Full Name | Wyoming Valley Infectious Disease Assoc, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 545 N River St, Wilkes Barre, Pennsylvania |
| Authorized Official Name and Position | Gary R Decker (OWNER) |
| Authorized Official Contact | 5708226036 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wyoming Valley Infectious Disease Assoc, Pc 545 N River St Suite 205 Wilkes Barre PA 18702-2600 Ph: (570) 822-6036 | Wyoming Valley Infectious Disease Assoc, Pc 545 N River St Suite 205 Wilkes Barre PA 18702-2600 Ph: (570) 822-6036 |
| NPI Number | 1154372373 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 11/19/2010 |
| Medicare PECOS PAC ID | 9234176058 |
|---|---|
| Medicare Enrollment ID | O20050413000781 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154372373 | NPI | - | NPPES |
| 756235 | Other | PA | HIGHMARK BLUE SHIELD |
| 809669 | Other | PA | FIRST PRIORITY |
| 010284600 | Other | PA | BLACK LUNG |
| 5507 | Other | PA | GEISINGER HEALTH PLAN |
| 0017767900002 | Medicaid | PA | |
| 756235 | Other | PA | FIRST PRIORITY LIFE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Lucyann M Sciandra |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1326096884 PECOS PAC ID: 7911959291 Enrollment ID: I20050215000429 |
| Provider Name | Gary Decker |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1144279209 PECOS PAC ID: 1153336912 Enrollment ID: I20111228000473 |
| Provider Name | Linda A Slavoski |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1386693687 PECOS PAC ID: 3678749363 Enrollment ID: I20111230000126 |
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