Provider Demographics
NPI:1922352079
Name:NEIGHBORHOOD FAMILY MEDICINE
Entity Type:Organization
Organization Name:NEIGHBORHOOD FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-864-2888
Mailing Address - Street 1:1214 BETHEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:SHICKSHINNY
Mailing Address - State:PA
Mailing Address - Zip Code:18655-3749
Mailing Address - Country:US
Mailing Address - Phone:570-864-2888
Mailing Address - Fax:
Practice Address - Street 1:1214 BETHEL HILL RD
Practice Address - Street 2:
Practice Address - City:SHICKSHINNY
Practice Address - State:PA
Practice Address - Zip Code:18655-3749
Practice Address - Country:US
Practice Address - Phone:570-864-2888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-27
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007533L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1205069416OtherINDIVIDUAL NPI KELLY L COPE
PAOS007533LOtherOSTEOPATHIC MEDICAL LICENSE
PA01405578Medicaid
PA1790778678OtherINDIVIDUAL NPI SCOTT S PRINCE
PAMA053999OtherALLOPATHIC PA-C
PAOA002907OtherOSTEOPATHIC PA-C
PAOA002907OtherOSTEOPATHIC PA-C
PA1790778678OtherINDIVIDUAL NPI SCOTT S PRINCE