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General NPI Number Information
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NPI Number | 1710951033
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Entity Type | Organization
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Legal Business Name | ALTOONA SPECIALITY CENTER LLC
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1125 OLD ROUTE 220 NORTH
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City | DUNCANSVILLE
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State | PA
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Zip | 16635
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Country | US
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Telephone | 814-693-0300
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Fax | 814-693-0400
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Provider Business Mailing Address
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Address Line | PO BOX 909
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City | DUNCANSVILLE
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State | PA
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Zip | 16635
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Country | US
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Telephone | 814-693-0300
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Fax | 814-693-0400
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Authorized Official
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Title or Position | CEO/CFO
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Name | DR. ALAN J KIVITZ
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Credential | MD
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Telephone | 814-693-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 1864
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License Number State | PA
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