Graduated: 2021
NPI: 1124786041
Practice Locations (2)
MEDICAL CENTER OF NORTHEASTERN PA LLC
511 PIERCE ST
KINGSTON, PA 187045731
5707143333
CHILDREN'S SERVICE CENTER OF WYOMING VALLEY INC
335 S FRANKLIN ST
WILKES BARRE, PA 187023808
5708256425581
Source: CMS National Downloadable File, September 2026.