Northeastern Surgical Specialty Group INC

NPI #1457381113 in Forty Fort, Pennsylvania

Provider Information

NPI Number: 1457381113
Entity Type: Organization
Organization Name: Northeastern Surgical Specialty Group INC
Primary Specialty: Surgery
Enumeration Date: Jul 5, 2006
Last Updated: Nov 1, 2012

Practice Location

Address: 190 WELLES ST
City: Forty Fort
State: Pennsylvania
ZIP Code: 18704-4968
Phone: (570) 283-2323

Authorized Official

Name: DAN F KOPEN, MD
Title: PRESIDENT
Phone: (570) 283-2323

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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