Basic Information
| Provider Information | |||||||||
| NPI: | 1457727810 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVANCED INPATIENT MEDICINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 183A MAINES ROAD | ||||||||
| Address2: | |||||||||
| City: | LAKEVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5706478990 | ||||||||
| FaxNumber: | 5703904389 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 E BROAD ST | ||||||||
| Address2: | |||||||||
| City: | HAZLETON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 182016835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5706478990 | ||||||||
| FaxNumber: | 5703904389 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2015 | ||||||||
| LastUpdateDate: | 08/19/2015 | ||||||||
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| AuthorizedOfficialLastName: | OCHS | ||||||||
| AuthorizedOfficialFirstName: | PAULA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CRNP | ||||||||
| AuthorizedOfficialTelephone: | 5709563337 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | FNP-C CRNP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | SP015152 | PA | Y | Hospitals | General Acute Care Hospital |
No ID Information.