Organization Name: | NORTHEASTERN OCCUPATIONAL MEDICINE & REHABILITATION CENTER, P.C. |
NPI Number: | 1104929470 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PATRICK J. FRICCHIONE (PRESIDENT) |
Mailing Address: | 769 Keystone Industrial Park Dunmore |
State: | PA US |
Postal Code: | 18512 |
Phone Number: | 5703417777 |
Fax Number: | 5703417789 |
NPI Enumeration Date: | 09/05/2006 |
NPI Last Update Date: | 02/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |