Provider Demographics
NPI:1891748877
Name:VALLEY GASTROENTEROLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:VALLEY GASTROENTEROLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JONI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CURRENT
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:724-891-2100
Mailing Address - Street 1:100 KNOWLSON AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1634
Mailing Address - Country:US
Mailing Address - Phone:724-891-2100
Mailing Address - Fax:724-891-2734
Practice Address - Street 1:100 KNOWLSON AVE
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1634
Practice Address - Country:US
Practice Address - Phone:724-891-2100
Practice Address - Fax:724-891-2734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA045616Medicare PIN