Emily Nebzydoski, MD | |
451 3rd Ave Ste 1, Kingston, PA 18704-5802 | |
(570) 288-6543 | |
(570) 288-7130 |
Full Name | Emily Nebzydoski |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 451 3rd Ave Ste 1, 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 |
---|---|---|---|
1386987873 | NPI | - | NPPES |
103131045 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | MD458096 (Pennsylvania) | Primary |
Entity Name | Scranton Quincy Clinic Company Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508143074 PECOS PAC ID: 0143487389 Enrollment ID: O20120131000544 |
Mailing Address | Practice Location Address |
---|---|
Emily Nebzydoski, MD 451 3rd Ave Ste 1, Kingston, PA 18704-5802 Ph: (570) 288-6543 | Emily Nebzydoski, MD 451 3rd Ave Ste 1, Kingston, PA 18704-5802 Ph: (570) 288-6543 |
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 | |
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 |