Avella Family Practice,llc | |
9 Campbell Dr Box 187 Avella PA 15312-2738 | |
(724) 587-3472 | |
(724) 587-5947 |
Full Name | Avella Family Practice,llc |
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Speciality | Family Medicine |
Location | 9 Campbell Dr, Avella, Pennsylvania |
Authorized Official Name and Position | Sean Matthew Porbin (OWNER) |
Authorized Official Contact | 7245873472 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Avella Family Practice,llc 1394 Avella Rd Avella PA 15312-3302 Ph: (724) 587-0296 | Avella Family Practice,llc 9 Campbell Dr Box 187 Avella PA 15312-2738 Ph: (724) 587-3472 |
NPI Number | 1659455988 |
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Provider Enumeration Date | 10/24/2006 |
Last Update Date | 07/15/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659455988 | NPI | - | NPPES |
1011626600001 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | MD063186L (Pennsylvania) | Primary |