Provider Demographics
NPI:1790707297
Name:POCONO MEDICAL CENTER
Entity Type:Organization
Organization Name:POCONO MEDICAL CENTER
Other - Org Name:POCONO INFECTIOUS DISEASES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-420-4970
Mailing Address - Street 1:206 E BROWN ST
Mailing Address - Street 2:POCONO HEALTHCARE MGMT. - PROFESSIONAL BLDG.
Mailing Address - City:E STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-3006
Mailing Address - Country:US
Mailing Address - Phone:570-476-3507
Mailing Address - Fax:570-476-3754
Practice Address - Street 1:500 PLAZA CT
Practice Address - Street 2:SUITE D
Practice Address - City:E STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-8262
Practice Address - Country:US
Practice Address - Phone:570-476-3778
Practice Address - Fax:570-421-3493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty