MEDICARE: NULTON DIAGNOSTIC & TREATMENT CENTER, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	314080	PA
2	251S00000X	Community/Behavioral Health Agency	117055	PA
3	2084P0800X	Psychiatry Physician
4	207Q00000X	Family Medicine Physician
5	2084P0005X	Neurodevelopmental Disabilities Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073573010
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NULTON DIAGNOSTIC & TREATMENT CENTER, PC

Provider Business Mailing Address
First Line	:	214 COLLEGE PARK PLAZA
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15904-2833
Country	:	US
Telephone Number	:	814-262-0025
Fax Number	:	814-266-8745

Provider Business Practice Location Address
First Line	:	214 COLLEGE PARK PLZ
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15904-2833
Country	:	US
Telephone Number	:	814-262-0025
Fax Number	:	814-266-8745

Authorized Official
Title or Position	:	BILLING DIRECTOR
Name	:	PATRICIA GRIESHEIMER
Credential	:
Telephone Number	:	814-262-0025

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	09/04/2014

Similar Medicare Providers

1023950821 — MICHELLE LYNN ZIMMERMAN
Practice Location Address:

214 COLLEGE PARK PLZ
JOHNSTOWN, PA
15904-2833

Practice Phone: 814-262-0025
Practice Fax:

1215997101 — MARTINA B LAURITO LCSW
Practice Location Address:

214 COLLEGE PARK PLZ
JOHNSTOWN, PA
15904-2833

Practice Phone: 814-262-0025
Practice Fax: 814-266-8745

1417906413 — LAWRENCE T BEATTY MD
Practice Location Address:

201 COLLEGE PARK PLAZA , SUITE 2
JOHNSTOWN, PA
15904-2833

Practice Phone: 814-266-8800
Practice Fax: 814-266-8175

1245269109 — GEORGIA KERRICK CRNP
Practice Location Address:

214 COLLEGE PARK PLZ
JOHNSTOWN, PA
15904-2833

Practice Phone: 814-262-0025
Practice Fax: 814-266-8745

1740219666 — CAROL SUSAN VIGNA LCSW
Practice Location Address:

214 COLLEGE PARK PLZ
JOHNSTOWN, PA
15904-2833

Practice Phone: 814-262-0025
Practice Fax: 814-266-8745

1760412712 — DAVID F HOLSINGER MD
Practice Location Address:

203 COLLEGE PARK PLZ
JOHNSTOWN, PA
15904-2833

Practice Phone: 814-961-3500
Practice Fax:

Directions to “NULTON DIAGNOSTIC & TREATMENT CENTER, PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.