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General NPI Number Information
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NPI Number | 1366564981
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Entity Type | Organization
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Legal Business Name | ELDERLY CARE PC
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 225 HUMPHREY RD SUITE 4
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City | GREENSBURG
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State | PA
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Zip | 15601-4571
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Country | US
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Telephone | 724-537-1678
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 292
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City | LATROBE
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State | PA
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Zip | 15650-0292
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Country | US
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Telephone | 724-537-1678
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Fax |
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Authorized Official
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Title or Position | PROPRIETOR
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Name | JOEL I LAST
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Credential | M.D.
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Telephone | 724-537-1678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD 040791-L
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License Number State | PA
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