Provider Demographics
NPI:1639374663
Name:FORGIONEPC
Entity Type:Organization
Organization Name:FORGIONEPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FORGIONE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:717-625-2607
Mailing Address - Street 1:321 REGENTS DR
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543
Mailing Address - Country:US
Mailing Address - Phone:717-625-2607
Mailing Address - Fax:717-625-2607
Practice Address - Street 1:321 REGENTS DR
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543
Practice Address - Country:US
Practice Address - Phone:717-625-2607
Practice Address - Fax:717-625-2607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA083534174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA083534Medicare ID - Type Unspecified
NJ068961Medicare ID - Type Unspecified