Healthcare Provider Details

I. General information

NPI: 1871053215
Provider Name (Legal Business Name): PETER BARRALE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N ACADEMY AVE
DANVILLE PA
17822-0001
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6089
  • Fax: 570-271-6002
Mailing address:
  • Phone: 570-271-6089
  • Fax: 570-271-6002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberMD488614
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: