Organization
BOSCO E NORONHA MD,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE WHETSEL (EMPLOYEE)
(724) 549-5764
Entity
Organization
Contact information
Practice address
1265 WAYNE AVE, SUITE 100, INDIANA, PA 15701-3501
(724) 349-5440
(724) 349-7445
Mailing address
1265 WAYNE AVE, SUITE 100, INDIANA, PA 15701-3501
(724) 349-5440
(724) 349-7445
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD072191L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD072191L
MEDICAL LICENSE
PA
Enumeration date
05/23/2016
Last updated
11/04/2016
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