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General NPI Number Information
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NPI Number | 1497887988
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Entity Type | Organization
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Legal Business Name | GREEN HILLS FAMILY MEDICAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 03/10/2007
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Last Update Date | 01/04/2010
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Provider Practice Location Address
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Address Line | 1903 MORGANTOWN ROAD
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City | READING
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State | PA
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Zip | 19607
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Country | US
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Telephone | 610-777-4040
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Fax | 610-777-5575
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Provider Business Mailing Address
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Address Line | 1903 MORGANTOWN ROAD
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City | READING
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State | PA
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Zip | 19607
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Country | US
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Telephone | 610-777-4040
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Fax | 610-777-5575
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Authorized Official
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Title or Position | MD/OWNER
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Name | DR. DIANE T. BONACCORSI
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Credential | M.D.
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Telephone | 610-777-4040
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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 | PA
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