Provider Demographics
NPI:1205417151
Name:NEPA FAMILY PRACTICE PLLC
Entity type:Organization
Organization Name:NEPA FAMILY PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-824-8151
Mailing Address - Street 1:220 S RIVER ST
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18705-1137
Mailing Address - Country:US
Mailing Address - Phone:570-824-8151
Mailing Address - Fax:570-824-0111
Practice Address - Street 1:220 S RIVER ST
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:PA
Practice Address - Zip Code:18705-1137
Practice Address - Country:US
Practice Address - Phone:570-824-8151
Practice Address - Fax:570-824-0111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty