Basic Information
| Provider Information | |||||||||
| NPI: | 1033123807 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRIMIANO | ||||||||
| FirstName: | GEORGE | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.D., M.B.A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 PLAZA CT STE C | ||||||||
| Address2: | |||||||||
| City: | EAST STROUDSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 183018263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704217020 | ||||||||
| FaxNumber: | 5704217091 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 PLAZA COURT | ||||||||
| Address2: | SUITE C | ||||||||
| City: | EAST STROUDSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 183018262 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704245180 | ||||||||
| FaxNumber: | 8663094265 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2006 | ||||||||
| LastUpdateDate: | 05/20/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | MD016274E | PA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0106X | MD016274E | PA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | 207XX0005X | MD016274E | PA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
No ID Information.