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449 Scranton Carbondale Hwy Dickson City PA 18508 | |
| (570) 344-6000 | |
| (570) 344-6002 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 449 Scranton Carbondale Hwy, Dickson City, Pennsylvania |
| Authorized Official Name and Position | Shahroon Riaz Choudhry (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5703446000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
449 Scranton Carbondale Hwy Scranton PA 18508-1115 Ph: (570) 344-6000 | 449 Scranton Carbondale Hwy Dickson City PA 18508 Ph: (570) 344-6000 |
| NPI Number | 1417402249 |
|---|---|
| Provider Enumeration Date | 08/22/2016 |
| Last Update Date | 11/15/2024 |
| Medicare PECOS PAC ID | 4688953953 |
|---|---|
| Medicare Enrollment ID | O20161110000122 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417402249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Shahroon R Choudhry |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942444641 PECOS PAC ID: 9133363062 Enrollment ID: I20130916000593 |
Cor Medicine, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 312 Boulevard Ave, Dickson City, PA 18519 Phone: 570-489-4567 Fax: 570-489-4534 | |
Mercy Group Practice Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 312 Boulevard Ave, Dickson City, PA 18519 Phone: 570-489-4567 Fax: 570-489-4534 | |
Geisinger Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Main Street, Dickson City, PA 18447 Phone: 570-489-8940 Fax: 570-489-3445 |