Provider Demographics
NPI:1699767087
Name:REMICK, PAUL FRANCIS (DO)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:FRANCIS
Last Name:REMICK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3 W OLIVE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508-2572
Mailing Address - Country:US
Mailing Address - Phone:570-961-9947
Mailing Address - Fax:570-341-5043
Practice Address - Street 1:1721 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-1903
Practice Address - Country:US
Practice Address - Phone:570-346-8417
Practice Address - Fax:570-344-3778
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0S004041-L207Q00000X
NJ25MB03520600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1094OtherFIRST PRIORITY HEALTH
PA0007055240001Medicaid
164317OtherBCBS
PAP00370794Medicare PIN
164317OtherBCBS
1094OtherFIRST PRIORITY HEALTH