Healthcare Provider Details

I. General information

NPI: 1003242140
Provider Name (Legal Business Name): ALLEGHENY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2013
Last Update Date: 06/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 EKASTOWN RD
SARVER PA
16055-9724
US

IV. Provider business mailing address

706 EKASTOWN RD
SARVER PA
16055-9724
US

V. Phone/Fax

Practice location:
  • Phone: 724-353-1508
  • Fax: 724-353-2040
Mailing address:
  • Phone: 724-353-1508
  • Fax: 724-353-2040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

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