| Northeast Knee And Joint Institute, Llc. | |
|
3832 Yalick Plaza Route 415 Unit 7 Dallas PA 18612-7753 | |
| (570) 213-5221 | |
| (570) 227-3316 |
| Full Name | Northeast Knee And Joint Institute, Llc. |
|---|---|
| Speciality | Physical Medicine & Rehabilitation |
| Location | 3832 Yalick Plaza Route 415, Dallas, Pennsylvania |
| Authorized Official Name and Position | Edwin Roman (OWNER) |
| Authorized Official Contact | 5702135221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Knee And Joint Institute, Llc. Po Box 3367 Williamsport PA 17701-0367 Ph: (570) 213-5221 | Northeast Knee And Joint Institute, Llc. 3832 Yalick Plaza Route 415 Unit 7 Dallas PA 18612-7753 Ph: (570) 213-5221 |
| NPI Number | 1689187072 |
|---|---|
| Provider Enumeration Date | 11/08/2017 |
| Last Update Date | 07/15/2019 |
| Medicare PECOS PAC ID | 5991067852 |
|---|---|
| Medicare Enrollment ID | O20180313001954 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689187072 | NPI | - | NPPES |
| Provider Name | Robert A Donato |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538150560 PECOS PAC ID: 9335034206 Enrollment ID: I20040318000545 |
| Provider Name | Boris Gabinskiy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417925496 PECOS PAC ID: 3375606445 Enrollment ID: I20090115000431 |
| Provider Name | Dilip K Elangbam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326008780 PECOS PAC ID: 8426122615 Enrollment ID: I20100310000083 |
| Provider Name | Joseph Louis Costa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578802864 PECOS PAC ID: 6305091893 Enrollment ID: I20130307000333 |
| Provider Name | Jeff Hiserman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336499615 PECOS PAC ID: 0446513022 Enrollment ID: I20180412001274 |
| Provider Name | Kelle Steinbacher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437653557 PECOS PAC ID: 6103180724 Enrollment ID: I20180508001392 |
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