Dr Fernando Carlos, MD | |
190 Welles St, Kingston, PA 18704-4968 | |
(570) 718-4140 | |
(570) 718-4141 |
Full Name | Dr Fernando Carlos |
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Gender | Male |
Speciality | Pediatrics |
Location | 190 Welles St, Kingston, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871590372 | NPI | - | NPPES |
1590725 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | MD 0583251 (Pennsylvania) | Secondary |
208000000X | Pediatrics | MD058325L (Pennsylvania) | Primary |
Entity Name | Geisinger Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366493868 PECOS PAC ID: 5395657001 Enrollment ID: O20040130000518 |
Mailing Address | Practice Location Address |
---|---|
Dr Fernando Carlos, MD 100 N Academy Ave, Danville, PA 17822-4903 Ph: (570) 271-6144 | Dr Fernando Carlos, MD 190 Welles St, Kingston, PA 18704-4968 Ph: (570) 718-4140 |
Jeffery R Kile, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 451 3rd Ave Ste 1, Kingston, PA 18704 Phone: 570-288-6543 Fax: 570-288-7130 | |
Vijay Kishore Prasad, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2 Sharpe St, Kingston, PA 18704 Phone: 570-491-0126 | |
Emily Nebzydoski, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 451 3rd Ave Ste 1, Kingston, PA 18704 Phone: 570-288-6543 Fax: 570-288-7130 | |
Dr. Alvaro G Reymunde, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 451 3rd Ave Ste 1, Kingston, PA 18704 Phone: 570-288-6543 Fax: 570-288-7130 | |
Basant Kumar Mittal, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 511 Pierce St, Kingston, PA 18704 Phone: 570-243-3300 Fax: 570-338-3993 | |
Tara Briane Churilla, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 451 3rd Ave Ste 1, Kingston, PA 18704 Phone: 570-288-6543 Fax: 570-288-7130 | |
Shaifali Gupta, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 190 Welles St, Kingston, PA 18704 Phone: 570-718-4140 Fax: 570-718-4141 |