MEDICARE: MARTIN G GREGORIO MD AND ASSOCIATES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD036862E	PA

General Provider Information

NPI Number	:	1548706799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTIN G GREGORIO MD AND ASSOCIATES PC

Provider Business Mailing Address
First Line	:	1500 VILLAGE RUN ROAD
Second Line	:	SUITE 308
City	:	WEXFORD
State	:	PA
Zip	:	15090
Country	:	US
Telephone Number	:	724-934-1900
Fax Number	:	724-934-3388

Provider Business Practice Location Address
First Line	:	1500 VILLAGE RUN RD
Second Line	:	SUITE 308
City	:	WEXFORD
State	:	PA
Zip	:	15090-6316
Country	:	US
Telephone Number	:	724-934-1900
Fax Number	:	724-934-3388

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MAUREEN ANN MCPEAK
Credential	:
Telephone Number	:	724-934-1900

Provider Enumeration Date	:	01/12/2017
Last Update Date	:	08/17/2020

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