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Organization
HERITAGE VALLEY MEDICAL GROUP, INC.
Active
Organization
HERITAGE VALLEY MEDICAL GROUP, INC.
Active
Parent organization
TRI-STATE MEDICAL GROUP, INC.
Other names
HVMG John D. Bayak M.D.
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRI-STATE MEDICAL GROUP, INC.
Authorized official
NORMAN F. MITRY (PRESIDENT & CEO)
(724) 773-4776
Entity
Organization
Contact information
Practice address
1254 RT 30, HILLENDALE HEALTH CENTER, CLINTON, PA 15026
(724) 573-5600
Mailing address
1254 RT 30, HILLENDALE HEALTH CENTER, CLINTON, PA 15026
(724) 573-5600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015654460023
—
PA
05
—
0202677
—
OH
Enumeration date
10/15/2008
Last updated
06/29/2012
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