North East Family Practice

NPI 1003064924 - Non-Pharmacy Dispensing Site - 332900000X

NPI Details
NPI 1003064924
Enumeration Date 09/04/2008
Last Updated 10/23/2012
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name KENNY KENNY
Position DIRECTOR OF OPERATIONS
Phone (814) 725-8774
Fax
Practice Location
115 E MAIN ST
NORTH EAST PA, 16428-1330, US
Phone (814) 725-8774
Fax
Business Location
5626 OBERLIN DR
SUITE 110
SAN DIEGO CA, 92121-1705, US
Phone
Fax
Toxanomy
Taxonomy Code 332900000X
License State Pennsylvania
License Number OS006274L
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According to our database, North East Family Practice NPI is 1003064924, taxonomy code is 332900000X and license number is OS006274L, license state is located at Pennsylvania. North East Family Practice physically located at 115 E Main St, North East PA, 16428-1330. NPI Number 1033115704 has the healthcare provider type.

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1003064924 NPI number is provided on an as is basis without warranty of any kind. 1003064924 is maintained by the National Plan & Provider Enumeration System. The contents of North East Family Practice are for informational purposes only.