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General NPI Number Information
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NPI Number | 1700864923
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Entity Type | Organization
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Legal Business Name | GASTROENTROLOGY ASSOCIATES OF ALLIANCE INC
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Dates
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Enumeration Date | 01/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 270 E STATE ST SUITE 110
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City | ALLIANCE
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State | OH
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Zip | 44601-4957
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Country | US
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Telephone | 330-829-0951
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Fax | 330-829-1949
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Provider Business Mailing Address
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Address Line | 270 E STATE ST SUITE 110
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City | ALLIANCE
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State | OH
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Zip | 44601-4957
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Country | US
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Telephone | 330-829-0951
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Fax | 330-829-1949
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | JOAN PADULA
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Credential |
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Telephone | 330-829-4344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 35-084462
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License Number State | OH
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