Provider Demographics
NPI:1518496173
Name:ALMAAN EL-ATTRACHE
Entity Type:Organization
Organization Name:ALMAAN EL-ATTRACHE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DETAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-864-5017
Mailing Address - Street 1:20 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-2094
Mailing Address - Country:US
Mailing Address - Phone:724-547-3576
Mailing Address - Fax:724-547-0242
Practice Address - Street 1:20 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-2094
Practice Address - Country:US
Practice Address - Phone:724-547-3576
Practice Address - Fax:724-547-0242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD458923207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1031376930001Medicaid