Organization
GREENVILLE OTOLARYNGOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GABRIEL ONG TE MD (PRESIDENT)
(724) 588-2772
Entity
Organization
Contact information
Practice address
11 LEECH RD, GREENVILLE, PA 16125-9724
(724) 588-2772
(724) 588-4017
Mailing address
11 LEECH RD, GREENVILLE, PA 16125-9724
(724) 588-2772
(724) 588-4017
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD-056338L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016239420004
—
PA
Enumeration date
03/30/2007
Last updated
11/19/2007
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