| Coordinated Care Of Kingston | |
|
183 Market St Kingston PA 18704-5444 | |
| (570) 714-9322 | |
| (570) 714-8750 |
| Full Name | Coordinated Care Of Kingston |
|---|---|
| Speciality | Internal Medicine |
| Location | 183 Market St, Kingston, Pennsylvania |
| Authorized Official Name and Position | Herbert Fellerman (PRESIDENT) |
| Authorized Official Contact | 5707149322 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coordinated Care Of Kingston 644 Gibson Ave Kingston PA 18704-5320 Ph: (570) 283-4806 | Coordinated Care Of Kingston 183 Market St Kingston PA 18704-5444 Ph: (570) 714-9322 |
| NPI Number | 1780709907 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4880651850 |
|---|---|
| Medicare Enrollment ID | O20041213000129 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780709907 | NPI | - | NPPES |
| 1376648444 | Other | PW | INDIVIDUAL NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | MD010836E (Pennsylvania) | Primary |
| Provider Name | Herbert Nmi Fellerman |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1376648444 PECOS PAC ID: 0143285361 Enrollment ID: I20041129000836 |
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