| Wyoming Valley Aids Council | |
|
330 Bowman St Unit 1 Wilkes Barre PA 18702-5448 | |
| (570) 823-5808 | |
| (570) 970-2717 |
| Full Name | Wyoming Valley Aids Council |
|---|---|
| Speciality | Internal Medicine |
| Location | 330 Bowman St, Wilkes Barre, Pennsylvania |
| Authorized Official Name and Position | Kenneth Zula (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5708235808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wyoming Valley Aids Council 330 Bowman St Unit 1 Wilkes Barre PA 18702-5448 Ph: (570) 823-5808 | Wyoming Valley Aids Council 330 Bowman St Unit 1 Wilkes Barre PA 18702-5448 Ph: (570) 823-5808 |
| NPI Number | 1588080824 |
|---|---|
| Provider Enumeration Date | 03/11/2014 |
| Last Update Date | 05/17/2024 |
| Medicare PECOS PAC ID | 8527398189 |
|---|---|
| Medicare Enrollment ID | O20190924002429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588080824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| 251B00000X | Case Management | (* (Not Available)) | Secondary |
| Provider Name | Militza E. Suarez-favetta |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1477652196 PECOS PAC ID: 4284798745 Enrollment ID: I20120104000295 |
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