Healthcare Provider Details
I. General information
NPI: 1891748877
Provider Name (Legal Business Name): VALLEY GASTROENTEROLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2006
Last Update Date: 09/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 KNOWLSON AVE
BEAVER FALLS PA
15010-1634
US
IV. Provider business mailing address
100 KNOWLSON AVE
BEAVER FALLS PA
15010-1634
US
V. Phone/Fax
- Phone: 724-891-2100
- Fax: 724-891-2734
- Phone: 724-891-2100
- Fax: 724-891-2734
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
JONI
MARIE
CURRENT
Title or Position: PRACTICE ADMINISTRATOR
Credential: MBA
Phone: 724-891-2100