Dr Susan Lynn Kaczorowski, MD | |
25 Church St, Wilkes Barre, PA 18702-3507 | |
(570) 808-8831 | |
(570) 808-8845 |
Full Name | Dr Susan Lynn Kaczorowski |
---|---|
Gender | Female |
Speciality | Pediatrics - Pediatric Critical Care Medicine |
Location | 25 Church St, Wilkes Barre, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689675431 | NPI | - | NPPES |
3810000934 | Medicaid | WV | |
2233827 | Medicaid | OH | |
0014069690003 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0203X | Pediatrics - Pediatric Critical Care Medicine | MD044881E (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 |
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Dr Susan Lynn Kaczorowski, MD 100 N Academy Ave, Danville, PA 17822-9800 Ph: (570) 271-6144 | Dr Susan Lynn Kaczorowski, MD 25 Church St, Wilkes Barre, PA 18702-3507 Ph: (570) 808-8831 |
Dr. Jasmine Vincent, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 25 Church St, Wilkes Barre, PA 18765 Phone: 570-808-3181 | |
Mrs. Connie Beiro Freeman, NNP Pediatrics Medicare: Medicare Enrolled Practice Location: 1000 E Mountain Blvd, Wilkes Barre, PA 18711 Phone: 570-808-7300 | |
Dr. Karen Ann Ephlin, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 166 Hanover St, Wilkes Barre, PA 18702 Phone: 570-808-6672 Fax: 570-808-6673 | |
Dr. Akila Venkataraman, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1000 E Mountain Blvd, Wilkes Barre, PA 18711 Phone: 570-808-7300 | |
Mr. Leopoldo Poblete Legaspi Jr., MD Pediatrics Medicare: Medicare Enrolled Practice Location: 25 Church St, Wilkes Barre, PA 18702 Phone: 570-808-3100 | |
Dr. Jayesh B Shah, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1000 E Mountain Blvd, Wilkes Barre, PA 18711 Phone: 570-808-8653 Fax: 570-808-8658 | |
Dr. Michelle K Sudo, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1102 Highway 315 Blvd, Wilkes Barre, PA 18702 Phone: 570-235-1470 Fax: 570-550-9356 |