Provider Demographics
NPI:1427362839
Name:BOLITHO, GILBERT ALAN (DO)
Entity Type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:ALAN
Last Name:BOLITHO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:LAHASKA
Mailing Address - State:PA
Mailing Address - Zip Code:18931
Mailing Address - Country:US
Mailing Address - Phone:215-794-7431
Mailing Address - Fax:215-794-7431
Practice Address - Street 1:6079 UPPER YORK ROAD
Practice Address - Street 2:
Practice Address - City:LAHASKA
Practice Address - State:PA
Practice Address - Zip Code:18931
Practice Address - Country:US
Practice Address - Phone:215-794-7431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003822L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine