Organization
JOSEPH E AMBROSE DO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH EDWARD AMBROSE DO (OWNER/PHYSICIAN)
(724) 349-9430
Entity
Organization
Contact information
Practice address
875 HOSPITAL ROAD, INDIANA, PA 15701-3662
(724) 463-9700
(724) 463-9702
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
05004831L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009281810005
—
PA
01
—
AM462289
PA BLUE SHIELD
PA
Enumeration date
05/23/2006
Last updated
10/23/2017
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