Organization
CLARION UNIVERSITY OF PENNSYLVANIA
Active
Other names
Northwest PA Rural AIDS Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH KUNDICK (FISCAL ADMINISTRATOR)
(814) 297-8220
Entity
Organization
Contact information
Practice address
15870 ROUTE 322, SUITE 2, CLARION, PA 16214-6338
(814) 764-6066
Mailing address
15870 ROUTE 322, SUITE 2, CLARION, PA 16214-6338
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
251B00000X
Case Management Agency
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002302280003
—
PA
Enumeration date
05/08/2007
Last updated
12/12/2019
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