Healthcare Provider Details

I. General information

NPI: 1255332623
Provider Name (Legal Business Name): GREGORY T HEBRANK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 SOUTH ST SUITE G-20
GREENSBURG PA
15601-2775
US

IV. Provider business mailing address

530 SOUTH ST SUITE G-20
GREENSBURG PA
15601-2775
US

V. Phone/Fax

Practice location:
  • Phone: 724-832-9190
  • Fax: 724-832-8705
Mailing address:
  • Phone: 724-832-9190
  • Fax: 724-832-8705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD029384E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: