MEDICARE: TIOGA HEALTHCARE PROVIDERS 8, INC

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	208600000X	Surgery Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DE9117	OTHER	PA	TRAVELERS MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	1809668	OTHER		HIGHMARK BS

General Provider Information

NPI Number	:	1306810957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIOGA HEALTHCARE PROVIDERS 8, INC

Provider Business Mailing Address
First Line	:	PO BOX 56
Second Line	:
City	:	WELLSBORO
State	:	PA
Zip	:	16901-0056
Country	:	US
Telephone Number	:	570-724-4670
Fax Number	:	570-724-3896

Provider Business Practice Location Address
First Line	:	15 MEADE ST
Second Line	:
City	:	WELLSBORO
State	:	PA
Zip	:	16901-1813
Country	:	US
Telephone Number	:	570-724-4670
Fax Number	:	570-724-3896

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DAVID CAHILL
Credential	:	MD
Telephone Number	:	570-724-4670

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	10/18/2007

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Directions to “TIOGA HEALTHCARE PROVIDERS 8, INC ” Practice Location

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