Provider Demographics
NPI:1427865997
Name:NORTHWELL HEALTH MEDICAL PA, P.C.
Entity type:Organization
Organization Name:NORTHWELL HEALTH MEDICAL PA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:
Authorized Official - Last Name:STRANGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-855-7538
Mailing Address - Street 1:116 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:DINGMANS FERRY
Mailing Address - State:PA
Mailing Address - Zip Code:18328-9801
Mailing Address - Country:US
Mailing Address - Phone:570-855-7538
Mailing Address - Fax:570-508-7035
Practice Address - Street 1:116 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:DINGMANS FERRY
Practice Address - State:PA
Practice Address - Zip Code:18328-9801
Practice Address - Country:US
Practice Address - Phone:570-855-7538
Practice Address - Fax:570-508-7035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty