Organization
FRG CENTRAL PA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY J. PISULA (COO)
(412) 551-0011
Entity
Organization
Contact information
Practice address
1001 E 2ND ST, COUDERSPORT, PA 16915-8161
(814) 274-9300
Mailing address
PO BOX 60, PITTSBURGH, PA 15230-0060
(412) 937-5726
(412) 937-5706
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022369280001
—
PA
Enumeration date
10/07/2008
Last updated
05/20/2009
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