| Northeast Gastroenterology Center, Inc. | |
|
10 Park Pl Hazle Township PA 18202-2885 | |
| (570) 454-1400 | |
| (570) 454-2144 |
| Full Name | Northeast Gastroenterology Center, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 10 Park Pl, Hazle Township, Pennsylvania |
| Authorized Official Name and Position | Young Kul Yoo (PRESIDENT) |
| Authorized Official Contact | 5704541400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Gastroenterology Center, Inc. 10 Park Place Hazle Township PA 18202-9394 Ph: (570) 454-1400 | Northeast Gastroenterology Center, Inc. 10 Park Pl Hazle Township PA 18202-2885 Ph: (570) 454-1400 |
| NPI Number | 1164509287 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 09/06/2012 |
| Medicare PECOS PAC ID | 2264410224 |
|---|---|
| Medicare Enrollment ID | O20040708000131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164509287 | NPI | - | NPPES |
| 513306 | Other | PA | AETNA |
| P006599 | Other | PA | TRICARE |
| 0016044280008 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Roy A Schaefer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154318145 PECOS PAC ID: 1759285018 Enrollment ID: I20031120000066 |
| Provider Name | Michelle R Huber |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447232707 PECOS PAC ID: 6901790591 Enrollment ID: I20040213000063 |
| Provider Name | Kimberley A Kretchmer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1225010770 PECOS PAC ID: 0143119008 Enrollment ID: I20040311000022 |
| Provider Name | Michelle A Davenport |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407887334 PECOS PAC ID: 6507851466 Enrollment ID: I20040419001440 |
| Provider Name | Christine M Rutkowski |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033152996 PECOS PAC ID: 7012994742 Enrollment ID: I20040701000341 |
| Provider Name | Charmaine M Kovacs |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255391744 PECOS PAC ID: 5193613230 Enrollment ID: I20040825001020 |
| Provider Name | Carol M Bialobrzeski |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750387957 PECOS PAC ID: 5597732537 Enrollment ID: I20040910000567 |
| Provider Name | Elaine T Carboni |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013966787 PECOS PAC ID: 7810965308 Enrollment ID: I20040922000711 |
| Provider Name | Karen M Khalife |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902897861 PECOS PAC ID: 3870537756 Enrollment ID: I20050613000024 |
| Provider Name | Diane J Butkus |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568464337 PECOS PAC ID: 5395776181 Enrollment ID: I20050822000751 |
| Provider Name | Michael A Yoder |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1346206752 PECOS PAC ID: 9032271580 Enrollment ID: I20090504000422 |
| Provider Name | Penny E Yenchick |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285619890 PECOS PAC ID: 2264586627 Enrollment ID: I20090819000480 |
| Provider Name | Gina Marie Chiplonia-swircek |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063480101 PECOS PAC ID: 7911077615 Enrollment ID: I20090930000405 |
| Provider Name | Charles T Ladoulis |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1538321609 PECOS PAC ID: 9436296563 Enrollment ID: I20091022000416 |
| Provider Name | John R Swircek |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912105180 PECOS PAC ID: 3173565876 Enrollment ID: I20091112000405 |
| Provider Name | Young-kul Yoo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1548243330 PECOS PAC ID: 4082779616 Enrollment ID: I20101104001346 |
| Provider Name | Ada A Spisak |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073587333 PECOS PAC ID: 4284605973 Enrollment ID: I20110513000685 |
| Provider Name | Susan L Kile |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386786077 PECOS PAC ID: 9032384334 Enrollment ID: I20111215000346 |
| Provider Name | Aliya A Lazinsky |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194096529 PECOS PAC ID: 7618136227 Enrollment ID: I20120316000276 |
| Provider Name | Linjun Xie |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1639242928 PECOS PAC ID: 3577730845 Enrollment ID: I20130208000411 |
| Provider Name | Charles C Nkamji |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841564739 PECOS PAC ID: 9436312378 Enrollment ID: I20150505001255 |
| Provider Name | Alan J Shienbaum |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1811967904 PECOS PAC ID: 1557406568 Enrollment ID: I20180906003271 |
| Provider Name | Jessica J Pawlowski |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447622451 PECOS PAC ID: 7517268220 Enrollment ID: I20190108000645 |
| Provider Name | Corrine Ann Joy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821553835 PECOS PAC ID: 1759621725 Enrollment ID: I20190329000893 |
| Provider Name | Ryan M Cristelli |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1356811939 PECOS PAC ID: 5092116830 Enrollment ID: I20210630001437 |
| Provider Name | Jeanine Chiaffarano |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1164810156 PECOS PAC ID: 4789952870 Enrollment ID: I20220602000986 |
| Provider Name | Calvin Sylvester Mann |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386607703 PECOS PAC ID: 1658375894 Enrollment ID: I20230907002811 |
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Greater Hazleton Gastroenterology, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10 Park Pl, Hazle Township, PA 18202 Phone: 570-617-6224 Fax: 570-454-2144 | |
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