Provider Demographics
NPI:1730104969
Name:NORTHWOOD HEALTH SERVICES PC
Entity type:Organization
Organization Name:NORTHWOOD HEALTH SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-424-1500
Mailing Address - Street 1:3729 EASTON NAZARETH HWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8344
Mailing Address - Country:US
Mailing Address - Phone:610-252-7410
Mailing Address - Fax:610-252-7380
Practice Address - Street 1:3729 EASTON NAZARETH HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8344
Practice Address - Country:US
Practice Address - Phone:610-252-7410
Practice Address - Fax:610-252-7380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA109825Medicare PIN
PA5967950001Medicare NSC