Provider Demographics
NPI:1225381528
Name:NAVAROLI MEDICAL
Entity Type:Organization
Organization Name:NAVAROLI MEDICAL
Other - Org Name:LATROY NAVAROLI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LATROY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:NAVAROLI
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CRNP
Authorized Official - Phone:814-726-7120
Mailing Address - Street 1:1 NEW ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-1551
Mailing Address - Country:US
Mailing Address - Phone:814-779-9199
Mailing Address - Fax:
Practice Address - Street 1:1 NEW ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-1551
Practice Address - Country:US
Practice Address - Phone:814-779-9199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP5104B261QM2500X, 282N00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No282N00000XHospitalsGeneral Acute Care Hospital