Provider Demographics
NPI:1073770533
Name:SCRANTON HEMATOLOGY ONCOLOGY
Entity Type:Organization
Organization Name:SCRANTON HEMATOLOGY ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:HYZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-558-3020
Mailing Address - Street 1:743 JEFFERSON AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1635
Mailing Address - Country:US
Mailing Address - Phone:570-558-3020
Mailing Address - Fax:570-558-3385
Practice Address - Street 1:743 JEFFERSON AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1635
Practice Address - Country:US
Practice Address - Phone:570-558-3020
Practice Address - Fax:570-558-3385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024781E207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010539300004Medicaid
PA0010539300004Medicaid