Provider Demographics
NPI:1700154325
Name:THE PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Entity Type:Organization
Organization Name:THE PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Other - Org Name:PENN STATE COLLEGE OF MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:FALVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-531-7674
Mailing Address - Street 1:500 UNIVERSITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17003
Mailing Address - Country:US
Mailing Address - Phone:717-531-0003
Mailing Address - Fax:717-531-5481
Practice Address - Street 1:500 UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17003
Practice Address - Country:US
Practice Address - Phone:717-531-0003
Practice Address - Fax:717-531-5481
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE PENNSYLVANIA STATE UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital