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General NPI Number Information
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NPI Number | 1568784072
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Entity Type | Organization
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Legal Business Name | GLADE RUN MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 02/25/2010
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 500 MEDICAL ARTS BLDG STE 540
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City | KITTANNING
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State | PA
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Zip | 16201-7137
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Country | US
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Telephone | 724-543-4942
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Fax | 724-543-8865
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Provider Business Mailing Address
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Address Line | 1 NOLTE DR
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City | KITTANNING
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State | PA
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Zip | 16201-7111
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Country | US
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Telephone | 724-543-8500
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Fax | 724-543-8616
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Authorized Official
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Title or Position | CEO
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Name | NICHOLE GERACI
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Credential |
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Telephone | 724-543-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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