NORTHEASTERN GASTROENTEROLOGY ASSOCIATES PC NPI 1942211248

NPI Information

  • NPI: 1942211248
  • Provider Name: NORTHEASTERN GASTROENTEROLOGY ASSOCIATES, PC
  • Classification: Internal Medicine - 207RG0100X
  • Specialization: Gastroenterology
  • Entity Type: Organization
  • CLIA Number: 39D2095434
  • Address: 1860 FAIR AVE
    SUITE A
    HONESDALE, PA
    ZIP 18431
  • Phone: (570) 253-3391

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NPI Details

NORTHEASTERN GASTROENTEROLOGY ASSOCIATES, PC is a gastroenterology internal medicine in Honesdale, PA. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. NORTHEASTERN GASTROENTEROLOGY ASSOCIATES, PC NPI is 1942211248. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1860 FAIR AVE
SUITE A
HONESDALE, PA
ZIP 18431-108
Phone: (570) 253-3391
Fax: (570) 253-1811

The provider's authorized official is David Dewitt Reynolds .
The authorized official title is President and has the following contact phone number (570) 253-3991.

The CLIA number assigned to this NPI record is 39D2095434 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/11/2006 and was last updated on 5/18/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0100XInternal MedicineGastroenterologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
166362OTHERPENNSYLVANIABLUE SHIELD
277790OTHERPENNSYLVANIABLUE SHIELD 65 SPECIAL
30450817000OTHERAMERIHEALTH & INDEP BS
4CG8812MEDICARE ID-TYPE UNSPECIFIEDMEDICARE RAILROAD
5N0001046MEDICARE ID-TYPE UNSPECIFIED
62400697OTHERGHI
7804251OTHERPENNSYLVANIAFIRST PRIORITY
80016721410006MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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