Provider Demographics
NPI:1215728704
Name:MED SPA AT BA LLC
Entity type:Organization
Organization Name:MED SPA AT BA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:AIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:724-454-1801
Mailing Address - Street 1:8489 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:N HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-5600
Mailing Address - Country:US
Mailing Address - Phone:724-454-1801
Mailing Address - Fax:724-590-5832
Practice Address - Street 1:8489 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:N HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-5600
Practice Address - Country:US
Practice Address - Phone:724-863-2442
Practice Address - Fax:724-590-5832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Single Specialty