Provider Demographics
NPI:1689998197
Name:NORTHWOOD HEALTH SERVICES, PC
Entity Type:Organization
Organization Name:NORTHWOOD HEALTH SERVICES, PC
Other - Org Name:NORTHEAST WOUND MANAGEMENT GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:CERINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-559-7110
Mailing Address - Street 1:3729 EASTON NAZARETH HWY
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8344
Mailing Address - Country:US
Mailing Address - Phone:610-559-7110
Mailing Address - Fax:610-253-3216
Practice Address - Street 1:3729 EASTON NAZARETH HWY STE 202
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8339
Practice Address - Country:US
Practice Address - Phone:610-252-7380
Practice Address - Fax:610-252-7380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA109825Medicare PIN