Provider Demographics
NPI:1407127012
Name:PALLONE FAMILY HEALTHCARE
Entity Type:Organization
Organization Name:PALLONE FAMILY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:HYSKELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-952-1500
Mailing Address - Street 1:531 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-2580
Mailing Address - Country:US
Mailing Address - Phone:814-938-7933
Mailing Address - Fax:814-938-7339
Practice Address - Street 1:531 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-2580
Practice Address - Country:US
Practice Address - Phone:814-249-7583
Practice Address - Fax:814-249-7584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
PASP009632363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty