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General NPI Number Information
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NPI Number | 1295020121
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Entity Type | Organization
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Legal Business Name | NESHANNOCK FAMILY PRACTICE-UPMC
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 06/20/2011
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Provider Practice Location Address
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Address Line | 3121 WILMINGTON RD
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City | NEW CASTLE
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State | PA
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Zip | 16105-1161
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Country | US
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Telephone | 724-656-3410
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Fax | 724-652-9282
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Provider Business Mailing Address
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Address Line | 3121 WILMINGTON RD
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City | NEW CASTLE
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State | PA
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Zip | 16105-1161
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Country | US
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Telephone | 724-656-3410
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Fax | 724-652-9282
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Authorized Official
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Title or Position | SR.DIRECTOR
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Name | MR. MARK EHALT
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Credential |
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Telephone | 412-647-0943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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