Organization
FAMILY MEDICINE OF WARREN, PA,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAT A BENGSTON (MANAGER)
(814) 726-3310
Entity
Organization
Contact information
Practice address
143 PLEASANT DR, WARREN, PA 16365-3371
(814) 726-3310
Mailing address
143 PLEASANT DR, WARREN, PA 16365-3371
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001181789
—
PA
Enumeration date
05/25/2006
Last updated
01/05/2010
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