Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lackawanna Medical Group PC

Organization Family Medicine Physician · NPI 1770650962

Lackawanna Medical Group PC is a Family Medicine Physician in Scranton, Pennsylvania. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
8
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

201 Smallacombe Dr
Scranton, PA 18508-2616
Phone: (570) 961-0171
Fax: (570) 207-2411
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X
Cardiovascular Disease Physician Taxonomy 207RC0000X
Gastroenterology Physician Taxonomy 207RG0100X
Nuclear Cardiology Physician Taxonomy 207UN0901X
Pediatrics Physician Taxonomy 208000000X
Physician Assistant Taxonomy 363A00000X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1770650962
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charles Grad — Business Manager · (570) 348-1130
NPI enumeratedNovember 30, 2006
Last updated in NPPESMarch 3, 2016
Mailing address201 Smallacombe Dr, Scranton, PA 18508-2616

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