Provider Demographics
NPI:1528603289
Name:CORE MEDICAL ALLIANCE PLLC
Entity Type:Organization
Organization Name:CORE MEDICAL ALLIANCE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:K
Authorized Official - Last Name:GEHIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-299-7502
Mailing Address - Street 1:400 ROUTE 315 HWY STE A
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18640-3912
Mailing Address - Country:US
Mailing Address - Phone:570-299-7502
Mailing Address - Fax:570-569-2250
Practice Address - Street 1:400 ROUTE 315 HWY STE A
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18640-3912
Practice Address - Country:US
Practice Address - Phone:570-299-7502
Practice Address - Fax:570-569-2250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-16
Last Update Date:2019-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty