Provider Demographics
NPI:1750650826
Name:PA PATIENT CARE PC
Entity Type:Organization
Organization Name:PA PATIENT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AHRON
Authorized Official - Middle Name:
Authorized Official - Last Name:MILWORM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:1718-664-7109
Mailing Address - Street 1:722 CLAY AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1728
Mailing Address - Country:US
Mailing Address - Phone:570-565-9111
Mailing Address - Fax:
Practice Address - Street 1:722 CLAY AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1728
Practice Address - Country:US
Practice Address - Phone:570-565-9111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC0700X
NY241004-1320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical DisabilitiesGroup - Single Specialty