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NPI Code Detail

MEDICARE: TRI STATE OBSTETRICS & GYNECOLOGY

MEDICARE: TRI STATE OBSTETRICS & GYNECOLOGY
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
1207VG0400XGynecology Physician
2207VX0000XObstetrics Physician
3207V00000XObstetrics & Gynecology Physician

Other Identifiers

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

General Provider Information

NPI Number : 1568419281
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRI STATE OBSTETRICS & GYNECOLOGY
Provider Business Mailing Address
First Line : 2 PEARTREE WAY
Second Line :
City : BEAVER
State : PA
Zip : 15009-1954
Country : US
Telephone Number : 724-773-6802
Fax Number : 724-770-7919
Provider Business Practice Location Address
First Line : 2580 CONSTITUTION BLVD
Second Line :
City : BEAVER FALLS
State : PA
Zip : 15010-1294
Country : US
Telephone Number : 724-843-0737
Fax Number : 724-770-7922
Authorized Official
Title or Position : PRESIDENT AND CEO
Name : NORMAN F MITRY
Credential :
Telephone Number : 724-773-4776
Provider Enumeration Date : 05/28/2006
Last Update Date : 07/08/2024

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Directions to “TRI STATE OBSTETRICS & GYNECOLOGY ” Practice Location

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