Provider Demographics
NPI:1841378098
Name:MATHUR HEALTH CARE
Entity type:Organization
Organization Name:MATHUR HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MINOR
Authorized Official - Suffix:
Authorized Official - Credentials:CST
Authorized Official - Phone:814-322-2348
Mailing Address - Street 1:2324 PORTAGE ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERHILL
Mailing Address - State:PA
Mailing Address - Zip Code:15958-3406
Mailing Address - Country:US
Mailing Address - Phone:814-243-8055
Mailing Address - Fax:
Practice Address - Street 1:2324 PORTAGE ST
Practice Address - Street 2:
Practice Address - City:SUMMERHILL
Practice Address - State:PA
Practice Address - Zip Code:15958-3406
Practice Address - Country:US
Practice Address - Phone:814-243-8055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD064804L207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherPHYSICIAN OFFICE