1711 East Broad Street Opco Llc

Specialty details in registry · Hazleton, PA

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At a glance

1711 E Broad St, Hazleton, PA 18201-5691

NPPES record updated Mar 10, 2025. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

1711 E Broad St
Hazleton, PA 18201-5691
Professional details: NPI, taxonomy & registry record
NPI1356159206
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
314000000X
Enumeration date
Dec 24, 2024
Record updated
Mar 10, 2025
More registry details
Provider type
Organization · Type 2
Other reported name
<UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

314000000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1711 E Broad St
Hazleton, PA 18201-5691
Phone
(570) 453-5100
Fax
(570) 453-5138
Mailing address
1711 E BROAD ST

HAZLETON, PA 182015691
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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