Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 05-115423-L | PA |
NPI | 1053315085 |
---|---|
Provider Name | Dr. John E Prior |
First Address | Scranton, PA 18510-1038 |
Second Address | Scranton, PA 18510-1038 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 23/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
077484 | FIRST PRIORITY (01) | PA |
1124737 | (05) | PA |
4101986 | AETNA (01) | PA |
B41194 | (02) | PA |