Provider Demographics
NPI:1831787399
Name:BARTOLOMUCCI FAMILY MEDICINE PLLC
Entity type:Organization
Organization Name:BARTOLOMUCCI FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BARTOLOMUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:724-420-5928
Mailing Address - Street 1:120 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-3787
Mailing Address - Country:US
Mailing Address - Phone:412-554-8451
Mailing Address - Fax:
Practice Address - Street 1:120 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-3787
Practice Address - Country:US
Practice Address - Phone:244-205-9287
Practice Address - Fax:724-219-3120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001467641Medicaid