Provider Demographics
NPI:1487830634
Name:FRANK GARY ROMASCAVAGE DO
Entity Type:Organization
Organization Name:FRANK GARY ROMASCAVAGE DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OSTEOPATHIC PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:ROMASCAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-992-5500
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:BRODHEADSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18322-0040
Mailing Address - Country:US
Mailing Address - Phone:570-992-5500
Mailing Address - Fax:570-992-2035
Practice Address - Street 1:ROUTE 209
Practice Address - Street 2:
Practice Address - City:BRODHEADSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18322-0040
Practice Address - Country:US
Practice Address - Phone:570-992-5500
Practice Address - Fax:570-992-2035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty