Organization
HERITAGE VALLEY MULTISPECIALTY 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
2719 BRODHEAD RD, ALIQUIPPA, PA 15001-2793
(724) 773-4776
Mailing address
1000 DUTCH RIDGE RD, BEAVER, PA 15009-9727
(724) 773-4776
(724) 773-4726
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
225X00000X
Occupational Therapist
—
—
246RP1900X
Phlebotomy Technician
—
—
247100000X
Radiologic Technologist
—
—
2471B0102X
Bone Densitometry Radiologic Technologist
—
—
2471C3401X
Computed Tomography Radiologic Technologist
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015654460023
—
PA
Enumeration date
11/05/2018
Last updated
10/02/2019
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