PEDIATRIC PRACTICES OF NORTHEASTERN PA
NPI 1033441092
Clinic/Center - Rural Health in Lake Ariel, PA

Q: What is Pediatric Practices Of Northeastern PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Active since February 02, 2010

62 INDUSTRIAL PARK RD, LAKE ARIEL, PA 18436(570) 689-7565(570) 689-4803 Get Directions Write a Review

NPPES record last updated: July 23, 2019. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Pediatric Practices Of Northeastern Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRIC PRACTICES OF NORTHEASTERN PA (NPI 1033441092) is a healthcare organization registered as a rural health in Lake Ariel, Pennsylvania and active in the NPI registry since February 2010. The organization maintains a secondary practice location in Honesdale and lists Robert Morton, Partner, as its authorized official.

NPPES Registry Identity

NPI1033441092

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NamePEDIATRIC PRACTICES OF NORTHEASTERN PA

Location Address62 INDUSTRIAL PARK RDLake Ariel, PA 18436-5606

Mailing Address1837 Fair AveHonesdale, PA 18431-2121 · (570) 689-7565 · Fax (570) 689-4803

Phone(570) 689-7565

Fax(570) 689-4803

Organization SubpartNo

Authorized OfficialRobert MortonPartner · (570) 253-5838

Enumeration DateFebruary 2, 2010

Last NPPES UpdateJuly 23, 2019

✔ NPI 1033441092 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

Also ListedPediatricsTaxonomy 208000000X

62 INDUSTRIAL PARK RD, Lake Ariel, PA 18436

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Other Names 1

Doing Business AsPediatric Practices Of Northeastern Pa

Secondary Practice Location 1

Location 11837 Fair AveHonesdale, PA 18431-2121 · Phone (570) 253-5838 · Fax (570) 253-6678

Other Identifiers 2

Medicaid1007422260016PA

Other39-3888PA · Cms Certification Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WAYNE MEMORIAL COMMUNITY HEALTH CENTERS

Clinic/Center (Federally Qualified Health Center (FQHC))