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Individual

MR. JOSEPH E. AMBROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
100 CHRISTY PARK DR, INDIANA, PA 15701-1584
(724) 349-9430
(724) 349-9431
Mailing address
100 CHRISTY PARK DR, INDIANA, PA 15701-1584
(724) 349-9430
(724) 349-9431

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS-0044831-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009281810005
PA
01
AM462289
PA BLUE SHIELD
PA
Enumeration date
07/20/2005
Last updated
10/01/2019
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