| Prime Aba | |
|
2000 Ash St Scranton PA 18510-1546 | |
| (570) 871-4751 | |
| (570) 955-5323 |
| Full Name | Prime Aba |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2000 Ash St, Scranton, Pennsylvania |
| Authorized Official Name and Position | Perla Edith Goldstein (OWNER/DIRECTOR) |
| Authorized Official Contact | 5708714751 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Aba 2000 Ash St Scranton PA 18510-1546 Ph: (570) 871-4751 | Prime Aba 2000 Ash St Scranton PA 18510-1546 Ph: (570) 871-4751 |
| NPI Number | 1225674740 |
|---|---|
| Provider Enumeration Date | 11/19/2019 |
| Last Update Date | 10/03/2023 |
| Certification Date | 10/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225674740 | NPI | - | NPPES |
| 103589790 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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