Provider Demographics
NPI:1336321793
Name:THOMAS F CARMEN
Entity Type:Organization
Organization Name:THOMAS F CARMEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:CARMEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-934-1900
Mailing Address - Street 1:11676 PERRY HWY
Mailing Address - Street 2:SUITE 1201
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090
Mailing Address - Country:US
Mailing Address - Phone:724-934-1900
Mailing Address - Fax:
Practice Address - Street 1:11676 PERRY HWY
Practice Address - Street 2:SUITE 1201
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090
Practice Address - Country:US
Practice Address - Phone:724-934-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036862E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA084958Medicare PIN