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Organization
MAINLINE MEDICAL ASSOCIATES INC
Active
Organization
MAINLINE MEDICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VAL MIGNOGNA (PRACTICE MANAGER)
(814) 941-8811
Entity
Organization
Contact information
Practice address
1400 9TH AVE, ALTOONA, PA 16602-2415
(814) 941-8811
(814) 941-8828
Mailing address
792 GALLITZIN RD, CRESSON, PA 16630-2213
(814) 886-8161
(814) 886-2955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
010099A
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001746002
—
PA
01
—
056175
HIGHMARK GROUP PROVIDER #
PA
Enumeration date
08/10/2006
Last updated
10/26/2012
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