Provider Demographics
NPI:1497924385
Name:LATROBE INTERNAL MEDICINE, INC.
Entity Type:Organization
Organization Name:LATROBE INTERNAL MEDICINE, INC.
Other - Org Name:DIAGNOSTIC ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE/BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBROSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-539-3555
Mailing Address - Street 1:1100 LIGONIER ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-1917
Mailing Address - Country:US
Mailing Address - Phone:724-539-3555
Mailing Address - Fax:724-539-1966
Practice Address - Street 1:1100 LIGONIER ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1917
Practice Address - Country:US
Practice Address - Phone:724-539-3555
Practice Address - Fax:724-539-1966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty