Provider Demographics
NPI:1578590980
Name:THE CENTER FOR INTEGRATIVE MEDICINE AT INNER HARMONY, PC
Entity Type:Organization
Organization Name:THE CENTER FOR INTEGRATIVE MEDICINE AT INNER HARMONY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:IRVING
Authorized Official - Last Name:EISENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-346-4621
Mailing Address - Street 1:743 JEFFERSON AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510
Mailing Address - Country:US
Mailing Address - Phone:570-346-4621
Mailing Address - Fax:570-346-5109
Practice Address - Street 1:743 JEFFERSON AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510
Practice Address - Country:US
Practice Address - Phone:570-346-4621
Practice Address - Fax:570-346-5109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018654700006Medicaid
PA048884Medicare ID - Type Unspecified