Organization
HERITAGE VALLEY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORMAN F MITRY (PRESIDENT & CEO)
(724) 773-4776
Entity
Organization
Contact information
Practice address
935 THORN RUN RD, SUITE 201, MOON TWP, PA 15108-2861
(724) 773-8388
Mailing address
935 THORN RUN RD, SUITE 201, MOON TWP, PA 15108-2861
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015654460023
—
PA
Enumeration date
05/19/2016
Last updated
05/19/2016
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