Provider Demographics
NPI:1023199098
Name:PEDIATRICS OF NEPA, PC
Entity Type:Organization
Organization Name:PEDIATRICS OF NEPA, PC
Other - Org Name:DRS DAWGERT ZUKOSKI & WELBY PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-346-1464
Mailing Address - Street 1:920 VIEWMONT DRIVE
Mailing Address - Street 2:
Mailing Address - City:DICKSON CITY
Mailing Address - State:PA
Mailing Address - Zip Code:18519
Mailing Address - Country:US
Mailing Address - Phone:570-346-1464
Mailing Address - Fax:570-346-7450
Practice Address - Street 1:920 VIEWMONT DRIVE
Practice Address - Street 2:
Practice Address - City:DICKSON CITY
Practice Address - State:PA
Practice Address - Zip Code:18519
Practice Address - Country:US
Practice Address - Phone:570-346-1464
Practice Address - Fax:570-346-7450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty