Healthcare Provider Details

I. General information

NPI: 1861667206
Provider Name (Legal Business Name): WEST PENN PHYSICIAN PRACTICE NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 CARLISLE ST ALLE-KISKI MEDICAL CENTER
NATRONA HEIGHTS PA
15065-1152
US

IV. Provider business mailing address

1301 CARLISLE ST ALLE-KISKI MEDICAL CENTER
NATRONA HEIGHTS PA
15065-1152
US

V. Phone/Fax

Practice location:
  • Phone: 724-224-5100
  • Fax: 412-330-5522
Mailing address:
  • Phone: 724-224-5100
  • Fax: 412-330-5522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: CECILI R JONES
Title or Position: ENROLLMENT ANALYST
Credential:
Phone: 412-330-4813