Healthcare Provider Details
I. General information
NPI: 1376815159
Provider Name (Legal Business Name): PINNACLE HEALTH MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/08/2012
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2151 LINGLESTOWN RD SUITE 100
HARRISBURG PA
17110-9499
US
IV. Provider business mailing address
3 WALNUT ST SUITE 206
LEMOYNE PA
17043-1168
US
V. Phone/Fax
- Phone: 717-545-4786
- Fax: 717-545-6359
- Phone: 717-761-0208
- Fax: 717-761-2023
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOSEPH
A
CINCOTTA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 717-761-0208