Healthcare Provider Details

I. General information

NPI: 1184614497
Provider Name (Legal Business Name): RALPH WILLIAM PASSARELLI III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 W NEWTON ST STE 100
GREENSBURG PA
15601-2890
US

IV. Provider business mailing address

522 W NEWTON ST STE 100
GREENSBURG PA
15601-2890
US

V. Phone/Fax

Practice location:
  • Phone: 724-853-8922
  • Fax: 724-853-8925
Mailing address:
  • Phone: 724-853-8922
  • Fax: 724-853-8925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD074277L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: