Organization
VALLEY ENT, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID I. BARRAS MD (PRESIDENT)
(570) 283-0524
Entity
Organization
Contact information
Practice address
190 WELLES ST, FORTY FORT, PA 18704-4968
(570) 283-0524
(570) 283-0302
Mailing address
190 WELLES ST, FORTY FORT, PA 18704-4968
(570) 283-0524
(570) 283-0302
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD020519E
PA
174400000X
Specialist
MD047846L
PA
174400000X
Specialist
MD430381
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001656096
HIGHMARK BLUE SHIELD
PA
Enumeration date
12/26/2006
Last updated
01/29/2009
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