HAZLETON PROFESSIONAL SERVICES (NPI# 1952464638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952464638 |
| Entity Type | Organization |
| Organization Name | HAZLETON PROFESSIONAL SERVICES |
| Other Organization Name | LEHIGH VALLEY PHYSICIAN GROUP-HAZLETON |
| Practice Address |
700 East Broad Street Hazleton PA 18201-6835 |
| Mailing Address |
Po Box 1830 Allentown PA 18105-1830 |
| Practice Telephone | 5705014584 |
| Practice Fax Number | 5705014754 |
| Mailing Telephone | 5705016368 |
| Mailing Fax Number | 5705014754 |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2019-07-23 |
| Authorized Official Name | MARYBETH BUTALA (INSURANCE ENROLLMENT SPECIALIST) |
| Authorized Official Telephone | 5705016368 |
| Is Organization Subpart | Y |
| Parent Organization Name | GREATER HAZLETON HEALTH ALLIANCE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1019653980001 | 05 | |
| PA | HIGHMARK BLUE SHIELD | 1954699 | 01 |
| Other Name | Type Code |
|---|---|
| Lehigh Valley Physician Group-Hazleton | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HAZLETON PROFESSIONAL SERVICES | 700 E Broad St, Hazleton, PA 18201-6835 |
| Street Address |
700 EAST BROAD STREET |
| City | HAZLETON |
| State | PA |
| Zip Code | 18201-6835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992335244 | Alfreda A Wujcik | Counselor | 750 E Broad Street, Hazleton, PA 18201 | 2020-01-24 |
| 1811468127 | Omni Health Services, Inc. | Peer Specialist | 1747 B East Broad Street, Hazleton, PA 18201 | 2018-12-13 |
| 1366956781 | Olivia Dworak | Pharmacist | Route 93 Laurel Mall, Hazleton, PA 18201 | 2017-11-21 |
| 1598283194 | Emily Heller | Massage Therapist | 780 N. Church St., Hazleton, PA 18201 | 2017-09-03 |
| 1053715425 | Md Enterprises LLC | In Home Supportive Care | 261 S Church St, Hazleton, PA 18201 | 2014-10-14 |
| 1154605772 | Michael A. Washinsky, Do | Family Medicine | 1730 E Borad Street, Suite1, Hazleton, PA 18201 | 2011-09-30 |
| 1205158185 | Sally Anne Malkin Gilbert | Pharmacist | Laurel Mall Route 93, Hazleton, PA 18201 | 2010-02-19 |
| 1790017176 | Michael John Portonova | Chiropractor | 943 North Church Street, Hazleton, PA 18201 | 2010-02-09 |
| 1598964330 | Anthony John Stachurski Jr. | Occupational Therapy Assistant | 1000 W. 27th St., Hazleton, PA 18201 | 2007-07-12 |
| 1801017819 | Stephen C Celani | Dentist | 21 East Broad St, Hazelton, PA 18201 | 2007-05-01 |
| Find all providers in zip 18201 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497042832 | Housam Haddad | Internal Medicine | 1740 East Broad St., Hazleton, PA 18201-3846 | 2011-07-06 |
| 1174858104 | Pedro Guzman | Internal Medicine | 141 N Cedar St, Hazleton, PA 18201-5580 | 2009-10-08 |
| 1760551105 | Rudolph Silas Fellin | Internal Medicine | 54 N Locust St, Hazleton, PA 18201-5770 | 2006-11-08 |
| 1508870148 | Howard J. Cox | Internal Medicine | 149 N. Vine St., Hazleton, PA 18201 | 2006-07-28 |
| 1497782536 | Anthony P Veglia | Internal Medicine | 1525 N Church St, Hazleton, PA 18202-9383 | 2006-06-26 |
| 1700825452 | Jude Francis Sidari | Internal Medicine | 235 W Chestnut St, Hazleton, PA 18201-6230 | 2006-06-06 |
| 1346218104 | Leocadia T Prawdzik | Internal Medicine | 1090 N Church St, Hazleton, PA 18202-1446 | 2006-03-09 |
| 1780668061 | Edward Stanley Polashenski | Internal Medicine | 128 W 14th St, Hazleton, PA 18201-3266 | 2005-12-01 |
| 1376527655 | Robert Yamulla | Internal Medicine | 128 West 14th St, Hazleton, PA 18201-3266 | 2005-12-01 |
| 1780681262 | Stephen N Shoemaker | Internal Medicine | 217 E 9th St, 1st Floor, Hazleton, PA 18201-3305 | 2005-06-30 |
| Find all providers in HAZLETON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.