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General NPI Number Information
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NPI Number | 1811954118
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Entity Type | Organization
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Legal Business Name | TRISTAN ASSOCIATES
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | 240 GRANDVIEW AVE
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City | CAMP HILL
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State | PA
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Zip | 17011
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Country | US
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Telephone | 717-652-5840
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Fax | 717-652-8152
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Provider Business Mailing Address
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Address Line | 4520 UNION DEPOSIT RD
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City | HARRISBURG
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State | PA
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Zip | 17111
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Country | US
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Telephone | 717-652-6105
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Fax | 717-652-2165
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Authorized Official
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Title or Position | CEO TRISTAN ASSOCIATES
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Name | PAUL DELOIA JR.
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Credential |
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Telephone | 717-652-6105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State | PA
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