| Strp Faculty Service | |
|
640 Madison Ave Scranton PA 18510-1607 | |
| (570) 961-5670 | |
| (570) 961-5991 |
| Full Name | Strp Faculty Service |
|---|---|
| Speciality | Internal Medicine |
| Location | 640 Madison Ave, Scranton, Pennsylvania |
| Authorized Official Name and Position | Elidoro Primero (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 5709410630 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Strp Faculty Service 746 Jefferson Ave Scranton PA 18510-1624 Ph: (570) 343-2383 | Strp Faculty Service 640 Madison Ave Scranton PA 18510-1607 Ph: (570) 961-5670 |
| NPI Number | 1851387013 |
|---|---|
| Provider Enumeration Date | 09/23/2005 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851387013 | NPI | - | NPPES |
| 0663952 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Pennsylvania) | Primary |
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