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Organization

BOSCO E NORONHA MD,PC

Active
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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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