| NPI | 1720850001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN NEJMAN Credentialing Specialist 814-868-2507 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2023-10-30 |