# AVELLA FAMILY PRACTICE,LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659455988
- **Authorized official:** DR. SEAN MATTHEW PORBIN M.D. (OWNER)
- **Authorized official phone:** (724) 587-3472

## Contact information

- **Practice address:** 9 CAMPBELL DR, BOX 187, AVELLA, PA 15312-2738
- **Practice address phone:** (724) 587-3472
- **Practice address fax:** (724) 587-5947
- **Mailing address:** 1394 AVELLA RD, AVELLA, PA 15312-3302
- **Mailing address phone:** (724) 587-0296

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD063186L | PA | Yes |

## Other

- **Enumeration date:** 10/24/2006
- **Last updated:** 07/15/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1011626600001 | — | PA |