| Medical Center Of Northeastern Pa Llc | |
|
511 Pierce St Kingston PA 18704-5731 | |
| (570) 243-3300 | |
| (570) 338-3993 |
| Full Name | Medical Center Of Northeastern Pa Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 511 Pierce St, Kingston, Pennsylvania |
| Authorized Official Name and Position | Ibrahim M Almeky (MD/OWNER) |
| Authorized Official Contact | 5702433300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Center Of Northeastern Pa Llc Po Box 1885 Kingston PA 18704-0885 Ph: (570) 243-3300 | Medical Center Of Northeastern Pa Llc 511 Pierce St Kingston PA 18704-5731 Ph: (570) 243-3300 |
| NPI Number | 1063715639 |
|---|---|
| Provider Enumeration Date | 12/21/2010 |
| Last Update Date | 12/08/2023 |
| Medicare PECOS PAC ID | 1951579762 |
|---|---|
| Medicare Enrollment ID | O20110721000872 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063715639 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Basant K Mittal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558427377 PECOS PAC ID: 7214029966 Enrollment ID: I20070825000071 |
| Provider Name | Ibrahim M Almeky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750477139 PECOS PAC ID: 7719074889 Enrollment ID: I20080102000355 |
| Provider Name | Stephanie Lilly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285101592 PECOS PAC ID: 4385981950 Enrollment ID: I20190122000938 |
| Provider Name | Soohan Mansuri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194179887 PECOS PAC ID: 1153617527 Enrollment ID: I20190909002304 |
| Provider Name | Heather Tiffany Rosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356906598 PECOS PAC ID: 1557788668 Enrollment ID: I20200903000005 |
| Provider Name | Rachel Dawn Matteucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831747898 PECOS PAC ID: 8527488790 Enrollment ID: I20201009001593 |
| Provider Name | Thomas Mickowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053997999 PECOS PAC ID: 8729457080 Enrollment ID: I20221207003216 |
| Provider Name | Glorymardy Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124786041 PECOS PAC ID: 2466821715 Enrollment ID: I20221208003289 |
| Provider Name | Joritta L Walton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942998091 PECOS PAC ID: 8628436938 Enrollment ID: I20230619001888 |
| Provider Name | Emily Margaret Rogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508594193 PECOS PAC ID: 7012379902 Enrollment ID: I20230809001349 |
Women To Women Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 3rd Ave, Park Office Building 208 209, Kingston, PA 18704 Phone: 570-714-5800 Fax: 570-714-0473 | |
Stanley Lobitz Md Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 155 E Bennett St, Kingston, PA 18704 Phone: 570-283-5611 Fax: 570-283-5613 | |
Choices Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 562 Wyoming Ave, Kingston, PA 18704 Phone: 570-552-3700 Fax: 570-552-3733 | |
Stanley A. Lobitz Md Michael F. Lombard Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 155 E Bennett St, Kingston, PA 18704 Phone: 570-283-5611 | |
Mo Medical Management Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 675 Wyoming Avenue, Kingston, PA 18704 Phone: 570-288-4205 Fax: 570-288-4889 | |
Susan F Sordoni, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 Pierce St, Suite 115, Kingston, PA 18704 Phone: 570-714-2999 Fax: 570-714-2903 |